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[Conservative treatment of neurogenic fecal incontinence. Our experience with children]
P Fernández Eire1, R Varela Cives, M Castro Gago
1Servicio de Cirugía Pediátrica, Hospital General de Galicia, Santiago de Compostela.
Insights
Retrograde colon enema effectively manages fecal incontinence in children with myelodysplasia. This treatment helps achieve rectal emptying, enabling 97% of patients to become diaper-free and improve social integration.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
- Neuro-Urology
Context:
- Fecal incontinence is a common and distressing symptom in children with myelodysplasia.
- Traditional management often involves diapers, impacting quality of life and social participation.
- Neurogenic bowel dysfunction in myelodysplasia necessitates effective management strategies.
Purpose:
- To evaluate the efficacy of retrograde colon enema (RCE) in managing fecal incontinence in pediatric patients with myelodysplasia.
- To assess the long-term outcomes of RCE regarding rectal continence and diaper independence.
- To determine the impact of RCE on the social adaptation of affected children.
Summary:
- A study involving 33 children (average age 11.9 years) with myelodysplasia and fecal incontinence utilized retrograde colon enema.
- The procedure resulted in successful rectal emptying for 97% of patients (32 children), who became diaper-free after over two years of follow-up.
- One patient required pads due to difficulties with defecation timing post-enema.
Impact:
- Retrograde colon enema offers a highly effective conservative treatment for neurogenic fecal incontinence in children.
- Achieving fecal continence through RCE significantly enhances children's social adaptation and integration.
- This minimally invasive approach improves quality of life for pediatric patients with myelodysplasia-related bowel dysfunction.
Objective:
The objective of this study was to present the use of retrograde colon enema in myelodysplasic patients with fecal incontinence.
Patients And Methods:
Thirty-three patients, 16 males and 19 females, 5 to 22 years old (average age 11.9 years) with spina bifida and fecal incontinence which obliged them to use a diaper. Retrograde colon enema procedures were performed in all of them.
Results:
With the use of the retrograde enema the best rectal emptying was achieved and kept 32 children (97%) diaper free after a follow-up period of more than two years. Only one girl (3%) needed pads because she was not able to defecate in an appropriate place after administering the enema.
Conclusions:
The retrograde enema is the best conservative treatment for children with neurogenic fecal incontinence. This method achieves good rectal emptying allowing the children to be diaper free, resulting in better social adaptation and integration.