Transanal Irrigation in the Treatment of Children With Functio. Constipation

[dr.j.cardey@wanadoo.fr]

Journal of Pediatric Gastroenterology and Nutrition
Transanal Irrigation in the Treatment of Children With Intractable Functional Constipation
J. Pediatr. Gastroenterol. Nutr. 2017 Feb 01;64(2)225-229, IJ Koppen, S Kuizenga-Wessel, HW Voogt, ME Voskeuil, MA Benninga

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Questionnaires were sent to families of children treated with Peristeen transanal irrigation for intractable functional constipation to evaluate the efficacy of this treatment and the subsequent parental satisfaction. Fecal incontinence was reported by 84% of children before treatment. Among children still using Peristeen at the time of survey, 41% reported complete resolution of fecal incontinence, 12% reported occasional fecal incontinence, and 47% still experienced fecal incontinence more than once a week. Pain on irrigation was reported by 42% of children. Most parents (86%) were satisfied with the treatment and 67% expressed a desire to continue the treatment.

Transanal irrigation is an effective and acceptable treatment for functional constipation in children, and further randomized studies are needed.

abstract

This abstract is available on the publisher’s site.
OBJECTIVES

The aim of the study was to assess the treatment efficacy of transanal irrigation and parental satisfaction in children with intractable functional constipation (FC) treated with Peristeen.
METHODS

Cross-sectional survey study among parents of children (age 0-18 years) treated with Peristeen for FC (based on the Rome III criteria). Anonymous questionnaires were sent out to parents via mail, these consisted of 25 self-developed, multiple-choice questions regarding the use of Peristeen, current gastrointestinal symptoms, adverse effects of Peristeen, concomitant medication use, and parental satisfaction.
RESULTS

Out of 91 invited families, 67 (74%) returned the questionnaire. In total, 84% of patients experienced fecal incontinence prior to treatment. Out of all children who still used Peristeen at the time of survey (n = 49), fecal incontinence had resolved completely in 41%, 12% experienced occasional episodes of fecal incontinence (<1 episode per week) and the remaining 47% still experienced episodes of fecal incontinence regularly (≥1 time per week). A total of 28 children (42%) experienced pain during rectal irrigation, especially during insertion of the catheter, inflating the balloon, or during irrigation. Overall, 86% of the parents were satisfied with the result of transanal irrigation and 67% reported that they would continue using transanal irrigation for the treatment of their child’s symptoms.
CONCLUSIONS

Transanal irrigation may be effective in the treatment of children with FC and renders a high parental satisfaction. Future prospective studies, preferably RCTs, are necessary to further evaluate this treatment option.

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