Long-Term Outcomes of Antegrade Continence Enemas to Treat Constipation and Fecal Incontinence in Children

Area of Science:

• Pediatric Gastroenterology
• Bowel Management
• Quality of Life Research

Background:

• Constipation and fecal incontinence significantly impact children's quality of life.
• Antegrade continence enema (ACE) is a treatment option for pediatric defecation disorders.
• Long-term outcomes of ACE treatment require further investigation.

Purpose of the Study:

• To investigate the long-term outcomes of antegrade continence enema (ACE) treatment in pediatric patients.
• To assess the impact of ACE on gastrointestinal health-related quality of life (HRQoL) and symptoms.
• To evaluate patient and parent satisfaction with ACE treatment.

Main Methods:

• Prospective cohort study of pediatric patients with organic or functional defecation disorders undergoing ACE treatment.
• Data collection at baseline and follow-up up to 60 months, including Pediatric Quality of Life Inventory Gastrointestinal Symptoms Module (PedsQL-GI) scores.
• Assessment of gastrointestinal symptoms, adverse events, and patient/parent satisfaction.

Main Results:

• Thirty-eight children were included, with diagnoses including functional constipation, anorectal malformation, and Hirschsprung disease.
• Significant improvements in PedsQL-GI scores were observed at 12 and 24 months for functional constipation and at 36 months for organic causes.
• Minor adverse events occurred in one-third of patients; 10% required surgical revision. The majority expressed willingness to choose ACE again.

Conclusions:

• Antegrade continence enema (ACE) treatment is positively perceived by pediatric patients and their parents.
• ACE can lead to sustained improvements in gastrointestinal health-related quality of life for children with defecation disorders.
• ACE is a viable long-term management option for complex pediatric bowel conditions.