Science Alert: Treatment of Children with Neurogenic Bladder and Bowel Dysfunction

Posted by Sofi Sigvardsson, August 22, 2017

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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.

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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.

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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.

http://journals.lww.com/tnpj/Abstract/2017/07000/Constipation_in_children__Diagnosis,_treatment,.8.aspx

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.

http://www.jcn.co.uk/files/downloads/articles/55775-jcn-apr-may-12-latest-developments-in-transanal-irrigation-therapy.pdf

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.

  


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This blog post is an extract of the Science Alert from July 2017 (76070-USX-1707)

Topics: Science Alert, Neurogenic bladder, Children and TAI, Bowel dysfunction