Bowel function in children is a common concern, not only for the child but also parents and caregivers. As it is perceived as a measurement of health, deviations from normal bowel function often instigate numerous visits to a primary care provider.
Consequently, bowel dysfunction is one of the most common problems evaluated by pediatricians, pediatric gastroenterologists, and pediatric surgeons. This may be the reason why two recent publications review diagnosis, standard bowel care, and prevention of pediatric constipation.
Transanal irrigation is considered to be a significant bowel management therapy in children for whom standard bowel care is ineffective, and several different products are available. One conference abstract reports preliminary data comparing Colotip® and Peristeen® in children with bowel dysfunction. Although no difference can be verified with only 7 patients, a trend in favor of Peristeen® is noticeable.
Transanal irrigation was first introduced to a group of children suffering from neurogenic bowel disorder as a result of spina bifida. Two new studies show that in the group of children with spina bifida, continence problems appear to have a significant impact on life quality.
Furthermore, children with spina bifida who suffer from urinary and stool incontinence had the lowest overall agreement between self- and medical record reporting. This indicates that continence is an important factor in every child’s life and needs to be taken seriously.
Evaluation and Management of Pediatric Constipation.
https://link.springer.com/article/10.1007%2Fs40746-017-0078-8
Author and Origin
Jiles K.A., Hamrick M.C. US
Summary
Review of bowel dysfunction in children, covering physiology, diagnosis and treatments in standard bowel care.
Conclusions
It is important to accept that constipation can be a severe, life-altering problem for children, and it should be addressed with an aggressive management strategy.
Comments
Review of bowel dysfunction in children with focus on functional bowel.
Patient control cross-over study between two different colon enema systems (colotip and peristeen) in children, preliminary results.
http://journals.lww.com/jpgn/Documents/ESPGHAN2017_Abstracts%20Publication%20JPGN_FINAL.pdf
Author and Origin
Van Renterghem K., Van Biervliet S., Ruth D.B., Van Winckel M., Velde S.V. Belgium
Summary
A study comparing bowel management using the colon enema systems Colotip and Peristeen in 7 children. The study is still ongoing.
Conclusions
There are no significant differences in continence, time spent on the toilet, or self-reliability according to the visual analog scale between the two products. This may be due to the small sample size. All patients and parents preferred using Peristeen.
Comments
Preliminary result from a study comparing the effectiveness of and satisfaction with Colotip and Peristeen in children.
Constipation in children: Diagnosis, treatment, and prevention.
Author and Origin
Ferrara L, Saccomano, SJ. US
Summary
Review of bowel constipation in children, covering epidemiology, psychological factors, diagnosis, and first line treatment (standard bowel care).
Conclusions
Childhood constipation is a health concern that can produce stress for parents and caregivers. Supporting and encouraging parents and caregivers are important for alleviating parental fear and concern.
Comments
Review of constipation in children, mainly focusing on psychology in children and parents or care givers.
Latest developments in transanal irrigation therapy.
Author and Origin
Holroyd S. UK
Summary
A nurse-focused overview of transanal irrigation, including indications, assessments, risk factors of different systems, and clinical considerations.
Conclusions
Transanal irrigation is a minimally invasive technique. However, it requires careful assessments, and ongoing support of the patient’s needs.
Comments
Review of transanal irrigation with nursing focus.
Health-related quality of life in non-paraplegic (ambulatory) children with myelomeningocele.
https://www.ncbi.nlm.nih.gov/pubmed/28656385
Author and Origin
Canaz H, Canaz G, Dogan I, Alatas I. Turkey
Summary
Observational study of health-related quality of life in 35 myelomeningocele patients using the Child Edition of the Child Health and Illness Profile (CHIP-CE).
Conclusions
Continence problems appear to have a significant impact on quality of life for myelomeningocele patients.
Comments
Study exploring the impact of incontinence on quality of life in children with myelomeningocele.
Agreement between electronic medical records and self-reported urologic domains in the National Spina Bifida Patient Registry (NSBPR): Implications for future research.
https://www.ncbi.nlm.nih.gov/pubmed/28655526
Author and Origin
Halline CG, Meyer T, Rosoklija I, Yerkes EB. US
Summary
Observational study in 176 pediatric spina bifida patients, investigating differences between self- and medical record reporting of continence status and personal bladder/bowel management.
Conclusions
A general strong agreement between self- and medical record reporting was found, but medically complex patients showed lower agreement. For example, patients with urinary and stool incontinence had the lowest overall agreement, with 69% and 74% respectively.
Comments
Study highlighting the importance of minimizing disagreement between self- and medical record reporting to ensure standardized data collection. This will ultimately help to improve outcomes among pediatric spinal bifida patients with bladder and bowel problems.
This blog post is an extract of the Science Alert from July 2017 (76070-USX-1707)
