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Assessment of neurogenic bowel symptoms with the bowel dysfunction score in children with spina bifida: a prospective
Insights
Children with spina bifida experience a lower quality of life related to bowel function compared to healthy peers. Current bowel management strategies did not significantly improve this quality of life in spina bifida patients.
Area of Science:
- Pediatric Urology
- Neuroscience
- Quality of Life Research
Background:
- Spina bifida significantly impacts children's quality of life, particularly concerning bowel function.
- Effective bowel management is crucial for improving the well-being of children with spina bifida.
Purpose of the Study:
- To compare the quality of life (QoL) related to bowel function in children with spina bifida versus healthy controls.
- To assess the effectiveness of different bowel management strategies in improving QoL for spina bifida patients.
Main Methods:
- The study utilized the validated Neurogenic Bowel Dysfunction Score (NBDS) questionnaire.
- Data were collected prospectively from 48 children with spina bifida and 50 healthy controls.
- Statistical analysis was performed using SPSS software (v.25).
Main Results:
- Children with spina bifida had a significantly higher median NBDS score (13.5) compared to controls (2), indicating poorer QoL (p < 0.001).
- Among spina bifida patients, various bowel management strategies, including retrograde rectal irrigations and laxatives, showed no significant difference in QoL.
- A substantial proportion of spina bifida patients (19%) were on no specific bowel treatment.
Conclusions:
- Children with spina bifida report a worse quality of life concerning bowel function despite active management.
- The lack of significant QoL differences between various bowel management approaches warrants further investigation.
- A longitudinal study is recommended to explore the underlying reasons for these findings and optimize care.
Aim:
To compare the quality of life (QoL) in children with spina bifida with a control group of their peers using a validated questionnaire, the Neurogenic Bowel Dysfunction Score (NBDS).
Methods:
The NBDS questionnaire was prospectively distributed to children attending a multi-disciplinary Spina Bifida clinic and healthy controls attending pediatric urology clinics. A score (out of 41) was assigned to each child based on their responses to the validated questionnaire. A lower score indicates better bowel function-related quality of life. SPSS software (v.25) was used for all statistical analysis.
Results:
There were 98 respondents to the questionnaire, 48 children with spina bifida and 50 controls. The average age of respondents was 7.88 years (3-16 years). Of those with Spina Bifida, 33 (69%) were on retrograde rectal irrigations, [19 (58%) Peristeen® system, 11 (33%) tube rectal irrigations, and 3 (9%) Willis system], 6 (12%) were on laxatives, and 9 (19%) were on no treatment. The median NBDS for Spina Bifida patients was significantly higher 13.5 (2-32) compared to the control group 2 (0-26, p < 0.001). Amongst Spina Bifida patients, there was no difference in quality of life between the modalities of bowel management (p = 0.203).
Conclusions:
Despite active bowel management, children with spina bifida report a worse quality of life compared to the control group. In those with spina bifida, the lack of a difference between various bowel management strategies, including no treatment, indicates the need for a longitudinal study to evaluate the basis for this unexpected finding.
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