Bowel management programme in patients with anorectal malformations.

Area of Science:

• Pediatric Surgery
• Colorectal Surgery
• Pediatric Gastroenterology

Background:

• Anorectal malformations (ARMs) often lead to bowel dysfunction, impacting social continence.
• Effective bowel management is crucial for improving quality of life in children post-ARM surgery.

Purpose of the Study:

• To establish an effective and practical bowel management protocol.
• To achieve social continence in children treated surgically for anorectal malformations.

Main Methods:

• A quasi-experimental study involving 80 children (>3 years) post-ARM surgery.
• Adaptation of a one-week bowel management boot camp using high-volume saline enemas.
• Assessment of incontinence and soiling scores before and after the intervention.

Main Results:

• The mean incontinence score decreased significantly from 5.375 to 3.637 (p<0.001).
• A significant improvement was observed in the soiling component (mean score difference 1.275, p<0.001).
• The protocol was adapted for institutional constraints and patient needs.

Conclusions:

• A modified bowel management program effectively improved bowel control in children with ARM.
• The protocol achieved social continence, managing incontinence and constipation post-surgical treatment.