Radiologically supervised bowel management program outcome in patients with chronic idiopathic constipation

Area of Science:

• Pediatric Gastroenterology
• Colorectal Surgery
• Radiology

Background:

• Chronic idiopathic constipation (CIC) significantly impacts children's quality of life.
• Previous treatments for CIC often fail, necessitating advanced management strategies.
• Radiologically supervised approaches offer a structured method for managing complex pediatric constipation.

Purpose of the Study:

• To evaluate the effectiveness of a radiologically supervised bowel management program (RS-BMP) for pediatric patients with CIC.
• To identify factors associated with treatment success or failure within the RS-BMP.

Main Methods:

• Retrospective analysis of 80 pediatric patients with CIC treated between July 2016 and October 2022.
• Review of treatment history, including prior therapies and surgical interventions.
• Assessment of outcomes, including success rates, medication use, and presence of megarectum and behavioral disorders.

Main Results:

• The RS-BMP demonstrated a 96% success rate in treating CIC.
• Senna (73%) and enemas (27%) were the primary treatments used in successful cases.
• Megarectum was prevalent in both successful (93%) and unsuccessful (100%) outcomes, while behavioral disorders were linked to poorer outcomes (11% unsuccessful).

Conclusions:

• The RS-BMP is a highly effective treatment for pediatric chronic idiopathic constipation.
• Senna and enemas, under radiological supervision, are key components of successful treatment.
• Behavioral disorders and megarectum are associated with treatment challenges in CIC.