Bowel training for children with neurogenic dysfunction: a follow-up

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.