[Success of antegrade enemas in children with functional constipation].

Abstract

AIM:

To assess the benefit of antegrade enemas via cecostomy in children with functional constipation unresponsive to medical treatment.

METHODS:

A retrospective chart review identified 19 children (12 male, age 10.4 +/- 4.3 yrs) who from 1998-2001 underwent placement of a cecostomy for administration of antegrade enemas. All children were neurologically normal, suffered from functional constipation; all had a history of using multiple medications, having daily soiling, and 65% had prior hospitalizations due to fecal impaction. Sixteen of 19 children had undergone colonic manometry which ruled out colonic inertia. One of 3 irrigation solutions: polyethylene glycol (65%), saline and glycerin solution mix (10%) and phosphate enema (25%) administered through the cecostomy everyday in 14 children or every other day in 5 children. We used a questionnaire to interview caregivers, a mean of 21.1 +/- 24.9 mo after cecostomy placement.

RESULTS:

In all patients antegrade enemas led to significant improvement of: bowel movements/wk (7.4 vs. 1.4, p < 0.001), soiling accidents/wk (1.1 vs. 6.1, p < 0.001), emotional health score (3.8 vs. 1.8, p < 0.001), overall health score (3.7 vs. 1.8, p < 0.001), number of medications for constipation (0.8 vs. 4.2, p < 0.001), number of missed school days/mo (1.3 vs. 10.5, p < 0.001), and number of physician office visits/yr (7.7 vs. 24.1, p < 0.002). Eight patients have been able to discontinue the use of the antegrade enemas within a mean of 19.9 +/- 14.2 mo after beginning treatment.

CONCLUSION:

Antegrade enemas are an alternative effective way for treating severe cases of functional constipation unresponsive to medical management.

• Authors: L Pensabene, N N Youssef, C Di Lorenzo
• Journal: La Pediatria medica e chirurgica : Medical and surgical pediatrics (Pediatr Med Chir) 2003 Mar-Apr Vol. 25 Issue 2 Pg. 126-30 ISSN: 0391-5387 [Print] Italy
• Vernacular Title: Efficacia di clisteri "anterogradi" in bambini con stipsi funzionale.
• PMID: 12916440 (Publication Type: English Abstract, Journal Article)

Topics

• Cecostomy
• Child
• Constipation (surgery, therapy)
• Enema
• Female
• Humans
• Male
• Retrospective Studies