Prospective quality of life outcomes in pediatric fecal incontinence following bowel management
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Aug 2021 · 1 min read
In brief
In brief
This prospective study of 342 children demonstrates that structured bowel management programs produce significant, sustained improvements in fecal incontinence control and quality of life. Within two weeks, participants showed marked increases in voluntary bowel movements and decreased incontinence episodes, with benefits maintained at one year.
Written by the GCMD Library team from the article.
Background: Severe fecal incontinence (FI) is common in patients both with and without anorectal malformations. Whether a formal bowel management program (BMP) has significant effects on FI, psychosocial development of the child, and caregiver stress is poorly understood. We hypothesize that BMP participation results in long-term clinical and quality of life (QOL) improvements for patients and caregivers.
Methods: Using a prospective cohort study over three years, 342 children (age 3-12 years) and caregivers were followed for one year after attending a week-long BMP, during which a regimen was tailored to promote daily stool evacuation.FI QOL was measured with the validated Cincinnati Fecal Incontinence Scale (CINCY-FIS), evaluating multiple subscales, including parental stress. Scores were obtained at multiple timepoints following BMP (baseline, 2 weeks, 3 months, 1 year).
Results: Within 2 weeks, BMP participation significantly improved FI with increased frequency of daily daytime voluntary bowel movements (20%-70%, p < 0.001) and decreased daily daytime and nighttimeinvoluntary bowel movements (60%-20%, p < 0.001; 30%-10%, p < 0.05). Marked improvements in CINCY-FIS were observed across multiple QOL subscales, with the greatest in parental stress, and sustained through one year.
Conclusions: BMP results in significant and sustained improvement in FI and QOL for patients and caregivers.
DOI: 10.1016/j.jpedsurg.2021.04.025