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Radiologically supervised bowel management program outcome in patients with chronic idiopathic constipation

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Abstract

Purpose

This study aimed to analyze our radiologically supervised bowel management program (RS-BMP) outcomes in patients with chronic idiopathic constipation (CIC).

Methods

A retrospective study was conducted. We included all patients with CIC who participated in our RS-BMP at Children´s Hospital Colorado from July 2016 to October 2022.

Results

Eighty patients were included. The average time with constipation was 5.6 years. Before our RS-BMP, 95% had received non-radiologically supervised treatments, and 71% had attempted two or more treatments. Overall, 90% had tried Polyethylene Glycol and 43% Senna. Nine patients had a history of Botox injections. Five underwent anterograde continence procedure, and one a sigmoidectomy. Behavioral disorders (BD) were found in 23%. At the end of the RS-BMP, 96% of patients had successful outcomes, 73% were on Senna, and 27% were on enemas. Megarectum was detected in 93% of patients with successful outcomes and 100% with unsuccessful outcomes (p = 0.210). Of the patients with BD, 89% had successful outcomes, and 11% had unsuccessful.

Conclusion

Our RS-BMP has been proven to be effective in treating CIC. The radiologically supervised use of Senna and enemas was the appropriate treatment in 96% of the patients. BD and megarectum were associated with unsuccessful outcomes.

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Abbreviations

ACE:

Antegrade continence enema

ADHD:

Attention-deficit/hyperactivity disorder

ASD:

Autism spectrum disorder

BD:

Behavioral disorders

RS-BMP:

Radiologically supervised bowel management program

CIC:

Chronic idiopathic constipation

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Funding

This research received no specific grant from public, commercial, or not-for-profit funding agencies.

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Authors and Affiliations

  1. Department of Surgery, Division of Pediatric Surgery, International Center for Colorectal and Urogenital Care at Children’s Hospital Colorado, Universtity of Colorado, 13213 E 16th Ave, Anschutz Medical Campus, Box 323, Aurora, CO, 80045, USA

    Alfredo Domínguez-Muñoz, Andrea Bischoff, Lea A. Wehrli, Laura Judd-Glossy, Lauren Schneider, Anne Merritt, Maura Wickham, Jill Ketzer, Víctor Rodriguez, Alberto Peña & Luis De La Torre

Authors
  1. Alfredo Domínguez-Muñoz
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  2. Andrea Bischoff
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  3. Lea A. Wehrli
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  4. Laura Judd-Glossy
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  5. Lauren Schneider
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  6. Anne Merritt
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  7. Maura Wickham
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  8. Jill Ketzer
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  9. Víctor Rodriguez
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  10. Alberto Peña
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  11. Luis De La Torre
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Contributions

Study conception and design: LT, AB, AD-M. Data acquisition: AD-M, LAW, JK, VR, LS, AM and MW. Analysis and data interpretation: LT, AD-M, LJ-G. Drafting of the manuscript: LT, AD-M. Critical revision: LT, AB, AP, AD-MM. Figures and Tables: LT, AB, AP, AD-M All authors reviewed the manuscript.

Corresponding author

Correspondence to Luis De La Torre.

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Domínguez-Muñoz, A., Bischoff, A., Wehrli, L.A. et al. Radiologically supervised bowel management program outcome in patients with chronic idiopathic constipation. Pediatr Surg Int 39, 229 (2023). https://doi.org/10.1007/s00383-023-05508-9

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