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Fecal incontinence in children

Patricia P Mello, Diego A Eifer, Elza D Mello
OBJECTIVE: To gather current evidence on the use of fiber for constipation treatment in pediatric patients. SOURCE OF DATA: Systematic review with meta-analysis of studies identified through Pubmed, Embase, LILACS and Cochrane databases published up to 2016. INCLUSION CRITERIA: Randomized controlled trials; patients aged between 1 and 18 years and diagnosed with functional constipation receiving or not drug treatment for constipation; articles published in Portuguese, English, Spanish, French, and German in journals accessible to the researchers...
February 20, 2018: Jornal de Pediatria
Ariani Widodo, Badriul Hegar, Yvan Vandenplas
AIM: To assess the knowledge of general pediatricians througout Indonesia about the diagnosis and treatment of childhood constipation. METHODS: A comprehensive questionnaire was distributed to general pediatricians from several teaching hospitals and government hospitals all over Indonesia. RESULTS: Data were obtained from 100 pediatricians, with a mean of 78.34 ± 18.00 mo clinical practice, from 20 cities throughout Indonesia. Suspicion of constipation in a child over 6 mo of age arises when the child presents with a decreased frequency of bowel movements (according to 87% of participants) with a mean of one bowel movement per 3...
February 8, 2018: World Journal of Clinical Pediatrics
Claire Zar-Kessler, Braden Kuo, Jaime Belkind-Gerson
BACKGROUND: Childhood constipation is common. Previously, internal anal sphincterotomy has been used for hypertensive/non-relaxing sphincters; however, recent benefit has been shown with Botulinum Toxin (BT) injections. The aim is to investigate BT, including response duration, symptom association and effectiveness in relation to sphincter dynamics. METHODS: Retrospective study of 164 children receiving sphincter BT for severe constipation unresponsive to medication management...
December 24, 2017: Journal of Pediatric Surgery
Kimberly S Jarczyk, Pam Pieper, Lori Brodie, Kelly Ezzell, Tina D'Alessandro
INTRODUCTION: Evidence suggests that urinary and fecal incontinence and abnormal voiding and defecation dynamics are different manifestations of the same syndrome. This article reports the success of an innovative program for care of children with incontinence and dysfunctional elimination. This program is innovative because it is the first to combine subspecialty services (urology, gastroenterology, and psychiatry) in a single point of care for this population and the first reported independent nurse practitioner-run specialty referral practice in a free-standing pediatric ambulatory subspecialty setting...
December 28, 2017: Journal of Pediatric Health Care
David F Grabski, Yinin Hu, Sara K Rasmussen, Eugene D McGahren, Jeffrey W Gander
INTRODUCTION: The Malone appendicostomy is a continent channel used for antegrade enemas. It requires daily cannulation and is susceptible to stenosis. We use an indwelling low-profile balloon button tube inserted through the appendix into the cecum for antegrade enemas. We hypothesized that this method is effective at managing constipation or fecal incontinence and is associated with a low rate of stenosis. METHODS: Children who underwent laparoscopic appendicostomy balloon button placement at our institution from January 2011 to April 2017 were identified...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Fatima Neemuchwala, Fahmida Ahmed, Samya Z Nasr
Cystic fibrosis (CF) patients are at risk for developing pelvic (urinary and/or fecal) incontinence due to progressive weakness of pelvic floor muscles secondary to recurrent episodes of coughing and respiratory infections. Many patients do not bring these symptoms to the attention of their health care providers because of social embarrassment and lack of knowledge of available effective treatment. Several studies have identified the prevalence of incontinence in CF adults and adolescents. However, few studies identified the problem in children with CF...
2017: Global Pediatric Health
Alessandro Fugazza, Barbara Bizzarri, Federica Gaiani, Marco Manfredi, Alessia Ghiselli, Pellegrino Crafa, Maria Clotilde Carra, Nicola de'Angelis, Gian Luigi de'Angelis
BACKGROUND: The role of endoscopic ultrasound (EUS) in the management of pancreatobiliary and digestive diseases is well established in adults, but it remains limited in children. The aim of this study was to evaluate the feasibility, safety, and clinical impact of EUS use in children. METHODS: This is a retrospective analysis of a prospectively acquired database of consecutive pediatric (< 18 years) patients presenting an indication for EUS for pancreatobiliary and gastrointestinal disorders...
December 6, 2017: BMC Pediatrics
Paweł Kroll, Ewa Gajewska, Jacek Zachwieja, Danuta Ostalska-Nowicka, Maciej Micker, Andrzej Jankowski
BACKGROUND: Clean intermittent catheterization (CIC) is a standard treatment for patients who are unable to empty the bladder. In the absence of the urethra or if catheterization through the urethra is problematic, a continent vesicostomy is used as a catheterizable conduit. The Malone procedure is an established treatment option for children with neurogenic constipation and fecal incontinence. OBJECTIVES: The aim of the study was to report the authors' experience with continent catheterizable conduits (CCCs) in children, to review the results and to determine the efficacy of the technique, with an emphasis on continence and the need for revision...
October 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Yong-Zhong Mao, Shao-Tao Tang, Shuai Li
OBJECTIVE: To compare treatment outcomes in children with Hirschsprung's disease who underwent treatment using the Duhamel or TERPT surgical procedures. METHODS: Medline, Cochrane, EMBASE, and Google Scholar databases were searched through December 26, 2016. Search strings included Hirschsprung's disease, fecal incontinence, transanal endorectal pull-through, and Duhamel operation. Randomized controlled studies (RCTs) and retrospective studies that compared the treatment of Hirschsprung's disease in with TERPT or Duhamel surgical procedures in neonates, infants, or children were included...
October 16, 2017: Journal of Pediatric Surgery
Justine Niemczyk, C Wagner, A von Gontard
Autism spectrum disorders (ASD) are defined by persistent deficits in reciprocal social interaction, communication, and language, as well as stereotyped and repetitive behavior. Functional incontinence, as well as ASD are common disorders in childhood. The aim of this systematic review was to give an overview of the co-occurrence of nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) in ASD, and vice versa, of ASD in children with incontinence. A systematic literature search of the terms "incontinence", "enuresis", and "encopresis" in combination with "autism" or "Asperger" in four databases (Scopus, PubMed, PsycInfo and Web of science) was conducted...
October 10, 2017: European Child & Adolescent Psychiatry
Joseph M Firriolo, Ingrid M Ganske, Carolyn M Pike, Catherine Caillouette, Heather R Faulkner, Joseph Upton, Brian I Labow
BACKGROUND: Pressure ulcers refractory to nonoperative management may undergo flap reconstruction. This study aims to evaluate the long-term outcomes and recurrence rates of flap reconstruction for pediatric pressure ulcers. METHODS: We reviewed the records of patients who underwent flap reconstruction for pressure ulcer(s) from 1995 to 2013. RESULTS: Twenty-four patients with 30 pressure ulcers, requiring 52 flaps were included. Ulcers were stages III and IV and mostly involved either the ischia (15/30) or sacrum (8/30)...
February 2018: Annals of Plastic Surgery
S M Mugie, I J N Koppen, M M van den Berg, P F C Groot, L Reneman, M B de Ruiter, M A Benninga
BACKGROUND: Decreased sensation of urge to defecate is often reported by children with functional constipation (FC) and functional nonretentive fecal incontinence (FNRFI). The aim of this cross-sectional study was to evaluate cerebral activity in response to rectal distension in adolescents with FC and FNRFI compared with healthy controls (HCs). METHODS: We included 15 adolescents with FC, 10 adolescents with FNRFI, and 15 young adult HCs. Rectal barostat was performed prior to functional magnetic resonance imaging (fMRI) to determine individual pressure thresholds for urge sensation...
October 4, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Luis De la Torre, Kimberly Cogley, Karla Santos, Otto Morales, Juan Calisto
BACKGROUND/PURPOSE: Fecal incontinence after a pull-through is associated with different factors, although damage to the anal canal seems to be the most important. The objective of this article is to identify the variables related to the presence of fecal control and colitis in a homogeneous group of children after pull-through. METHODS: A retrospective cross-sectional study was performed in patients with HD for evaluation of post-operative problems from May 2014 to November 2016...
December 2017: Journal of Pediatric Surgery
Lucy Collins, Brennan Collis, Misel Trajanovska, Rija Khanal, John M Hutson, Warwick J Teague, Sebastian K King
BACKGROUND: Morbidity following repair of Hirschsprung disease (HD) is common. However, quality of life (QoL) results focused on HD children are contradictory. We aimed to measure QoL outcomes in HD children using validated questionnaires. METHODS: Patients with HD, managed at a large tertiary pediatric institution between 2004 and 2013, were identified. Parents completed validated questionnaires. Results were compared with published healthy population controls...
December 2017: Journal of Pediatric Surgery
Noor L H Bekkali, Daniël R Hoekman, Olivia Liem, Marloes E J Bongers, Michiel P van Wijk, Bas Zegers, Rolf A Pelleboer, Wim Verwijs, Bart G P Koot, Maksym Voropaiev, Marc A Benninga
OBJECTIVE: The long-term efficacy and safety of polyethylene glycol (PEG) in constipated children are unknown, and a head-to-head comparison of the different PEG formulations is lacking. We aimed to investigate noninferiority of PEG3350 with electrolytes (PEG3350 + E) compared to PEG4000 without electrolytes (PEG4000). METHODS: In this double-blind trial, children aged 0.5 to 16 years with constipation, defined as a defecation frequency of <3 times per week, were randomized to receive either PEG3350 + E or PEG4000...
January 2018: Journal of Pediatric Gastroenterology and Nutrition
Barbara Iwańczak, Franciszek Iwańczak
In the work diagnostic criteria of functional disorders of the gastrointestinal tract in children and adolescents aged 4 to 18 years are presented. The criteria were elaborated by experienced experts in pediatrics and gastroenterology and were presented on Digestive Disease Week in San Diego in 2016 as modified IV Rome Criteria. In the work the following functional disorders are discussed: cyclic vomiting syndrome, functional nausea and vomiting, rumination syndrome, aerophagia, functional dyspepsia, irritable bowel syndrome, abdominal migraine, functional abdominal pain - not otherwise specified, functional constipation, nonretentive fecal incontinence...
August 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Isabelle Beaudry-Bellefeuille, Shelly J Lane
The development of bowel control is an important activity of daily living in early childhood, and challenges in this area can limit participation in key occupations. Retentive fecal incontinence (RFI) is a common disorder in children. Up to 50% of children do not respond adequately to initial medical intervention, and behaviors around toileting, some related to sensory overresponsivity (SOR), may be partly responsible. Therefore, this study investigated the relationship between RFI and SOR and also examined the discriminative validity of the Toileting Habit Profile Questionnaire (THPQ)...
September 2017: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
Swathi Muddasani, Amanda Moe, Caitlin Semmelrock, Caroyl Luan Gilbert, Valentine Enemuo, Eric Howard Chiou, Bruno Pedro Chumpitazi
OBJECTIVES: To determine the efficacy of physical therapy (PT) for fecal incontinence in children with pelvic floor dyssynergia (PFD). STUDY DESIGN: Retrospective chart review of children with PFD completing >1 PT session for fecal incontinence at a quaternary children's hospital. The frequency of fecal incontinence (primary outcome), constipation-related medication use, number of bowel movements (in those with <3 per week at baseline) and pelvic floor muscle (PFM) function were captured at baseline and at the final PT visit...
November 2017: Journal of Pediatrics
P L Lu, I J N Koppen, D K Orsagh-Yentis, K Leonhart, E J Ambeba, K J Deans, P C Minneci, S Teich, K A Diefenbach, S A Alpert, M A Benninga, D Yacob, C Di Lorenzo
OBJECTIVE: To evaluate the long-term efficacy of sacral nerve stimulation (SNS) in children with constipation and describe patient benefit and parent satisfaction. METHODS: Using a prospective patient registry, we identified patients <21 years old with constipation treated with SNS for >2 years. We compared symptoms, medical treatment, PedsQL Gastrointestinal Symptom Scale (GSS), Fecal Incontinence Quality of Life Scale (FIQL), and Fecal Incontinence Severity Index (FISI) before SNS and at follow-up...
August 10, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Katarzyna Wojtyniak, Hania Szajewska
We updated our 2010 systematic review on the efficacy of probiotics in the treatment of constipation in children. The MEDLINE, EMBASE, and Cochrane Library databases; clinical trial registries; and reference lists of included studies were searched to February 2017 for randomized controlled trials (RCTs) performed in children, with no language restriction. The primary outcome measure was treatment success, as defined by the investigators. We included seven RCTs with a total of 515 participants. Included trials were heterogeneous with respect to study population, probiotic strains, dosages, study duration, and follow-up...
September 2017: European Journal of Pediatrics
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