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Rectal prolapse in older children associated with behavioral and psychiatric disorders

Shelley Reynolds Hill1, Peter F Ehrlich, Barbara Felt

  • 1Section of Pediatric Surgery, Department of Surgery, Mott Children's Hospital, 1540 E. Hospital Dr., SPC 4211, Ann Arbor, MI, 48109-4211, USA.

Pediatric Surgery International
|July 12, 2015
PubMed

Insights

Pediatric rectal prolapse (RP) in children over three may be linked to behavioral/psychiatric disorders (BPD). Multidisciplinary therapy including physical and behavioral interventions can reduce RP recurrence and severity.

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Psychiatry

Background:

  • Rectal prolapse (RP) in children over three is challenging, with frequent recurrences after surgical correction.
  • Underlying contributing factors, potentially including behavioral/psychiatric disorders (BPD), may play a role in pediatric RP.
  • A multidisciplinary approach is crucial for managing pediatric RP.

Purpose of the Study:

  • To investigate the relationship between pediatric rectal prolapse (RP) and behavioral/psychiatric disorders (BPD).
  • To describe the incidence of recurrence in pediatric RP patients with and without BPD.
  • To evaluate the effectiveness of various therapeutic tactics, including behavioral and physical therapy, in managing pediatric RP.

Main Methods:

  • Retrospective 20-year review of pediatric patients (age >3) diagnosed with rectal prolapse (RP).
  • Patient charts were analyzed for gastrointestinal, connective tissue, and BPD conditions, recurrence rates, and therapeutic interventions.
  • Therapies assessed included surgical correction, behavioral therapy, and physical therapy.

Main Results:

  • 53% of pediatric RP patients (21/39) had associated behavioral/psychiatric disorders (BPD).
  • Recurrence rates were similar between patients with and without BPD.
  • A 5-year program involving pelvic floor strengthening, behavior modification, and biofeedback showed reduced prolapse frequency and severity in eight patients, avoiding surgery in three.

Conclusions:

  • Pediatric rectal prolapse (RP) in older children may be associated with behavioral/psychiatric disorders (BPD).
  • A combined approach of behavioral therapy, physical therapy, and surgical intervention offers optimal outcomes.
  • Non-surgical therapies like pelvic floor strengthening and behavior modification show promise in managing pediatric RP.
Abstract

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