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Transanal Irrigation in the Treatment of Children With Intractable Functional Constipation
Ilan J N Koppen1, Sophie Kuizenga-Wessel, Heleen W Voogt
1*Department of Pediatric Gastroenterology and Nutrition †Department of Pediatric Surgery, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
Insights
Transanal irrigation using Peristeen may effectively treat intractable functional constipation in children, with high parental satisfaction reported. Further research is needed to confirm these findings.
Area of Science:
- Pediatric Gastroenterology
- Medical Device Technology
Background:
- Functional constipation (FC) is a common pediatric gastrointestinal disorder.
- Intractable FC often requires advanced treatment strategies.
Purpose of the Study:
- To evaluate the efficacy of transanal irrigation with Peristeen for treating pediatric functional constipation.
- To assess parental satisfaction with Peristeen treatment in children with intractable FC.
Main Methods:
- A cross-sectional survey study involving parents of children (0-18 years) treated with Peristeen for FC.
- Anonymous questionnaires assessed Peristeen use, GI symptoms, adverse effects, and parental satisfaction.
Main Results:
- Out of 49 current users, 41% had complete resolution of fecal incontinence.
- 86% of parents were satisfied with transanal irrigation outcomes.
- 42% of children experienced pain during irrigation, primarily during catheter insertion or balloon inflation.
Conclusions:
- Transanal irrigation with Peristeen shows potential effectiveness for pediatric FC.
- High parental satisfaction suggests a positive treatment experience.
- Further prospective studies, including RCTs, are recommended to validate efficacy.
Objectives:
The aim of the study was to assess the treatment efficacy of transanal irrigation and parental satisfaction in children with intractable functional constipation (FC) treated with Peristeen.
Methods:
Cross-sectional survey study among parents of children (age 0-18 years) treated with Peristeen for FC (based on the Rome III criteria). Anonymous questionnaires were sent out to parents via mail, these consisted of 25 self-developed, multiple-choice questions regarding the use of Peristeen, current gastrointestinal symptoms, adverse effects of Peristeen, concomitant medication use, and parental satisfaction.
Results:
Out of 91 invited families, 67 (74%) returned the questionnaire. In total, 84% of patients experienced fecal incontinence prior to treatment. Out of all children who still used Peristeen at the time of survey (n = 49), fecal incontinence had resolved completely in 41%, 12% experienced occasional episodes of fecal incontinence (<1 episode per week) and the remaining 47% still experienced episodes of fecal incontinence regularly (≥1 time per week). A total of 28 children (42%) experienced pain during rectal irrigation, especially during insertion of the catheter, inflating the balloon, or during irrigation. Overall, 86% of the parents were satisfied with the result of transanal irrigation and 67% reported that they would continue using transanal irrigation for the treatment of their child's symptoms.
Conclusions:
Transanal irrigation may be effective in the treatment of children with FC and renders a high parental satisfaction. Future prospective studies, preferably RCTs, are necessary to further evaluate this treatment option.