Functional Nonretentive Fecal Incontinence: Do Enemas Help?

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• 作者：Rosa Burgers ; MD¹ ; ^{r.e.burgers@amc.nl} ; Johannes B. Reitsma ; MD² ; Marloes E.J. Bongers ; MD¹ ; Fleur de Lorijn ; MD¹ ; Marc A. Benninga ; MD¹
• 关键词：CTT ; Colonic transit time ; FI ; Fecal incontinence ; FNRFI ; Functional nonretentive fecal incontinence ; GEE ; Generalized estimating equations model
• 刊名：The Journal of Pediatrics
• 出版年：2013
• 出版时间：May, 2013
• 年：2013
• 卷：162
• 期：5
• 页码：1023-1027
• 全文大小：155 K

文摘

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Objective

To assess the current treatment of functional nonretentive fecal incontinence, which consists of education, toilet training, and positive motivation.

Study design

Patients, age 6 years and older, referred for fecal incontinence (FI) and diagnosed with functional nonretentive fecal incontinence were eligible candidates. Seventy-one children (76 % boys, median age 9.3 years) were randomized to receive conventional therapy (control group) or conventional therapy in addition to daily enemas during 2 weeks. Treatment success was defined as <2 episodes of FI/month without use of enemas.

Results

At intake, the median FI frequency was 6.1 per week, whereas the median defecation frequency was 7.0 per week. At the end of the treatment period, the median number of FI episodes was significantly decreased in both groups: from 7.0 (IQR 4.0-11.5) to 1.0 (IQR 0.5-2.0) in the intervention group and from 6.0 (IQR 4.0-10) to 2.0 (IQR 0.5-3.5) in the control group. No statistical difference was found between the groups at the end of the treatment period (P?=?.08) nor during additional follow-up (average success rate 17 % for both groups, P?=?.99).

Conclusion

Temporarily application of additional rectal enemas did not significantly improve treatment success compared with conventional therapy alone.