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.

中文翻译：

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肠道管理后小儿大便失禁的预期生活质量结果

背景

严重大便失禁 (FI) 在有或没有肛门直肠畸形的患者中都很常见。正式的肠道管理计划 (BMP) 是否对 FI、儿童的社会心理发展和照顾者的压力有显着影响尚不清楚。我们假设 BMP 的参与会导致患者和护理人员的长期临床和生活质量 (QOL) 改善。

方法

使用一项为期三年的前瞻性队列研究，在参加为期一周的 BMP 后对 342 名儿童（3-12 岁）和护理人员进行了为期一年的随访，在此期间制定了促进每日排便的方案。经验证的辛辛那提大便失禁量表 (CINCY-FIS)，评估多个分量表，包括父母压力。在 BMP 之后的多个时间点（基线、2 周、3 个月、1 年）获得分数。

结果

在 2 周内，BMP 参与显着改善了 FI，增加了每日白天自愿排便的频率（20%–70%，p  < 0.001），并减少了每日白天和夜间非自愿排便（60%–20%，p  < 0.001；30%） –10%，p  < 0.05）。在多个 QOL 分量表中观察到 CINCY-FIS 的显着改善，父母压力最大，并持续了一年。

结论

BMP 可显着持续改善患者和护理人员的 FI 和 QOL。