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Transanal irrigation is effective in functional fecal incontinence

  • Original Article
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European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Functional fecal incontinence (FFI) is divided into cases related to functional constipation (FC) and cases without concomitant constipation termed functional non-retentive fecal incontinence (FNRFI). Transanal irrigation (TAI) is widely used in children with neurogenic fecal incontinence but is less studied in children with functional defecation disorders. The aim was to evaluate the feasibility and efficacy of TAI in the treatment of FFI. A retrospective study in 72 children (mean age 9.2 ± 2.2 years, 47 males) with treatment-resistant FFI was performed. All children accepted treatment and 35% (n = 25) were titrated to daily sessions. Of the 63 children who fulfilled the Rome III criteria of constipation, 46 (73%) showed full response with complete remission of incontinence episodes. Eleven (17%) showed partial response (≥50% reduction). Of nine children with FNRFI, four (44%) showed full response whereas two (22%) showed partial response. We found no significant difference in the reduction of incontinence episodes between the children with FC (87%) and children with FNRFI (68%) (p = 0.11).

Conclusion: TAI is an effective, well-tolerated, and safe choice in children with FC. No clinical parameters seemed to predict response to treatment. The number of children with FNRFI was low, but TAI seemed effective in this group of children.

What is Known:

• Functional fecal incontinence (FFI) is a frequent, chronic condition with significant impact on children’s quality of life.

• Transanal irrigation (TAI) is used in children with neurogenic bowel dysfunction but less studied in children with functional defecation disorders.

What is New:

• TAI seems an effective, well-tolerated, and safe choice in children with FFI due to functional constipation.

• Albeit the number of children with functional non-retentive fecal incontinence was low in our study, TAI seems effective also in this group of children.

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Abbreviations

ACE:

Antegrade continence enema

ICCS:

The International Children’s Continence Society

FC:

Functional constipation

FNRFI:

Functional non-retentive fecal incontinence

FFI:

Functional fecal incontinence

TAI:

Transanal irrigation

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Authors and Affiliations

  1. Center for Child Incontinence, Department of Paediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark

    Cecilie Siggaard Jørgensen, Konstantinos Kamperis, Charlotte Siggaard Rittig & Søren Rittig

  2. HC Andersen Children Hospital, Odense University Hospital, Odense, Denmark

    Line Modin

Authors
  1. Cecilie Siggaard Jørgensen
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  2. Konstantinos Kamperis
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  3. Line Modin
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  4. Charlotte Siggaard Rittig
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  5. Søren Rittig
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Contributions

Cecilie Siggaard Jørgensen—contribution: study design, data collection, data analysis, and writing the first draft. Konstantinos Kamperis—contribution: study design, data analysis, and critical revision of manuscript. Line Modin—contribution: study design, and critical revision of manuscript. Charlotte Siggaard Rittig—contribution: study design, and critical revision of manuscript. Søren Rittig—contribution: study design, data analysis, and critical revision of manuscript.

Corresponding author

Correspondence to Cecilie Siggaard Jørgensen.

Ethics declarations

The project was preformed according to the regulations of The Central Denmark Region Committees on Health Research Ethics. For this type of study, formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

No grants or financial support has been received.

Additional information

Revisions received: 21 March 2017 / 23 March 2017

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Jørgensen, C.S., Kamperis, K., Modin, L. et al. Transanal irrigation is effective in functional fecal incontinence. Eur J Pediatr 176, 731–736 (2017). https://doi.org/10.1007/s00431-017-2902-3

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  • DOI: https://doi.org/10.1007/s00431-017-2902-3

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