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Systematic review and meta-analysis of behavioral interventions for fecal incontinence with constipation

Kurt A Freeman1, Andrew Riley2, Danny C Duke2

  • 1Division of Psychology, Institute on Development & Disability, Oregon Health & Science University and Department of Public Health and Preventative Medicine, Oregon Health & Science University freemaku@ohsu.edu.

Journal of Pediatric Psychology
|June 14, 2014
PubMed

Insights

Behavioral interventions effectively treat fecal incontinence with constipation in children. However, more high-quality research is needed to clarify the best treatment strategies for pediatric fecal incontinence.

Area of Science:

  • Pediatric gastroenterology
  • Clinical trial analysis
  • Evidence-based medicine

Background:

  • Fecal incontinence management in children often involves behavioral approaches.
  • The comparative effectiveness of these behavioral strategies is not well-established.

Purpose of the Study:

  • To systematically review randomized controlled trials on behavioral treatments for fecal incontinence with constipation in children aged 4-18 years.
  • To synthesize evidence using mixed treatment comparisons and random effects models.

Main Methods:

  • Systematic review of randomized controlled trials.
  • Mixed treatment comparisons (MTCs) and random effects models were employed.
  • Risk of bias and quality of evidence were assessed.

Main Results:

  • Behavioral interventions demonstrated greater effectiveness compared to control conditions for improving success rates and reducing soiling frequency.
  • While 10 studies were considered for MTCs, reliable estimates were not obtained; four studies were used for pooled analysis.

Conclusions:

  • Current evidence supports the use of behavioral treatments for pediatric fecal incontinence with constipation.
  • Limited evidence necessitates further high-quality trials to elucidate the relative benefits of various behavioral strategies.
Abstract

Keywords:
encopresisevidence-based practicefecal incontinencemeta-analysissystematic review

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