Related Experiment Videos
Bowel training for children with neurogenic dysfunction: a follow-up
Insights
Inpatient bowel regulation training significantly reduced stool incontinence in children with neurogenic bowel dysfunction. Follow-up showed sustained improvements, with programs adapted for family lifestyles.
Area of Science:
- Pediatric Gastroenterology
- Neurorehabilitation
- Urology
Background:
- Neurogenic bowel dysfunction (NBD) and fecal incontinence significantly impact children's quality of life.
- Management often involves intensive bowel regulation training.
- Long-term outcomes and adaptations of these programs require further investigation.
Purpose of the Study:
- To evaluate the long-term effectiveness of inpatient bowel regulation training for children with NBD and fecal incontinence.
- To identify factors influencing the sustainability of improved bowel management.
- To assess the impact of program modifications on home routines.
Main Methods:
- A cohort of 50 children with NBD and fecal incontinence underwent inpatient bowel regulation training.
- Participants were interviewed an average of 1.2 years post-discharge.
- Data collected included incontinence frequency and adjustments made to the bowel program.
Main Results:
- The frequency of stool incontinence episodes decreased significantly from 1.8 per week before discharge to 0.9 per week at follow-up (p < 0.025).
- Bowel programs were frequently modified to integrate into individual home environments and family lifestyles.
- These adaptations were crucial for maintaining program adherence and effectiveness.
Conclusions:
- Inpatient bowel regulation training offers a sustainable solution for managing fecal incontinence in children with NBD.
- Individualized program adjustments are essential for long-term success and improved quality of life.
- Rehabilitation teams should consider family dynamics and home environments when developing and modifying bowel management plans.
Abstract:
Fifty children with neurogenic bowel dysfunction and stool incontinence received in patient bowel regulation training and were interviewed an average of 1.2 years later. Twenty-eight were males. Mean age was 13.5 years (range 5.6 to 18.9 years). Of the 50 children, 27 (54%) had myelomeningocele; 21 (2%), spinal cord lesion; and 27/2 (4%), repaired imperforate ani. Frequency of stool incontinence decreased from 1.8 episodes for the week prior to discharge to 0.9 episodes for the same period preceding follow-up interview (p less than 0.025). Significant changes occurred in the recommended bowel program in order to accommodate individual home environment and family life styles. Contributory factors accounting for these changes are discussed in light of specific guidelines for the rehabilitation team.