Related Experiment Video
Updated: Aug 11, 2026
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Tap-water enema for children with myelomeningocele and neurogenic bowel dysfunction
1Department of Molecular and Clinical Medicine, Division of Paediatrics, Faculty of Health Sciences, University Hospital, Linköping, Sweden. sven.mattsson@lio.se
Insights
Transrectal irrigation (TRI) with tap water effectively manages constipation and fecal incontinence in children with myelomeningocele and neurogenic bowel dysfunction. However, it does not promote independent toileting skills.
Area of Science:
- Pediatric Gastroenterology
- Neuroscience
- Urology
Background:
- Myelomeningocele often leads to neurogenic bowel dysfunction, causing significant challenges like constipation and fecal incontinence.
- Effective bowel management is crucial for the quality of life in children with myelomeningocele.
Purpose of the Study:
- To assess the efficacy and safety of transrectal irrigation (TRI) using clean tap water in children with myelomeningocele and neurogenic bowel issues.
- To evaluate the impact of TRI on constipation, fecal incontinence, rectal volume, anal sphincter pressure, and plasma sodium levels.
Main Methods:
- A cohort of 40 children with myelomeningocele and neurogenic bowel dysfunction underwent daily or every-other-day TRI using a stoma cone irrigation set.
- Parental questionnaires assessed outcomes related to fecal incontinence, constipation, and self-management at a median of 1.5 years post-intervention.
- Objective measures included rectal volume, anal sphincter pressure, and plasma sodium levels, evaluated before and after TRI initiation.
Main Results:
- Transrectal irrigation was successful in 85% (35/40) of children, resolving constipation and achieving fecal continence in most participants.
- Improvements were observed in rectal volume and anal sphincter pressure, with plasma sodium levels remaining within normal limits, indicating a safe intervention.
- While effective for bowel management, the majority of children found TRI time-consuming, and only one achieved independent use.
Conclusions:
- Transrectal irrigation with tap water presents a safe and effective method for managing constipation and fecal incontinence in pediatric patients with myelomeningocele and neurogenic bowel dysfunction.
- The intervention significantly improves key physiological parameters related to bowel control but does not foster independence in toileting.
- Further strategies may be needed to support children in achieving self-management and independence at the toilet.
Aim:
To evaluate the outcome of transrectal irrigation (TRI) using clean tap water without salt in children with myelomeningocele and neurogenic bowel problems.
Methods:
40 children (21 boys and 19 girls; aged 10 mo to 11 y) with myelomeningocele and neurogenic bowel dysfunction were treated with TRI given by a stoma cone irrigation set daily or every second day. A questionnaire on the effects on faecal incontinence, constipation and self-management was completed by the parents, 4 mo-8 y (median 1.5 y) after start. Effects on rectal volume, anal sphincter pressure and plasma sodium were evaluated before and after the start of irrigation.
Results:
At follow-up, 35 children remained on TRI, four had received appendicostomy, while one defecated normally. For all children but five (35/40; 85%) the procedure worked satisfactorily, but a majority found the procedure very time consuming and only one child was able to perform it independently. All children were free of constipation; most (35/40) were also anal continent. Rectal volume and anal sphincter pressure improved, while plasma sodium values remained within the normal range.
Conclusion:
Transrectal irrigation with tap water is a safe method to resolve constipation and faecal incontinence in children with myelomeningocele and neurogenic bowel dysfunction, but it does not help children to independence at the toilet.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:22Aneurysm IV: Nursing Management
01:23Lower GI Series: Barium Enema
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
01:26The Micturition Reflex
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
01:21Drugs for Treatment of Constipation-Predominant IBS
01:20Drugs Affecting GI Tract Motility: Other Laxatives
Osmotic or saline laxatives, like magnesium hydroxide or milk of...