A Systematic Approach to Bowel Continence for Children with Spina Bifida

Leibold, Susan

doi:10.1055/s-2008-1042532

Cited by 9 publications

(4 citation statements)

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“…[1][2][3][4][5] A stepwise approach is the proposed therapeutic strategy in achieving fecal pseudocontinence in patients with SB. 1,6,7 Continence treatment is started from age 5 using a strict toileting scheme, manual evacuation or digital stimulation. When this approach fails, starting use of large volume colon enemas is proposed.…”

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confidence: 99%

Colon Enemas for Fecal Incontinence in Patients with Spina Bifida

et al. 2013

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confidence: 99%

Colon Enemas for Fecal Incontinence in Patients with Spina Bifida

et al. 2013

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“…Furthermore, sphincter control is an important indicator of social activity, independence, and development (25,26). Urinary and fecal incontinence results in major social problems (27)(28)(29)(30). These studies suggest that physical problems may negatively affect physicosocial status.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Functional Status and Quality of Life in Children with Spina Bifida

Şahin¹,

Albayrak²,

Durmuş³

et al. 2014

Turk J Phys Med Rehab

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Objective: The aim of this study was to determine functional status and QoL of children with spina bifida (SB) by using the Functional Independence Measure for Children (WeeFIM) and the Child Health Questionnaire PF-50 (CHQPF-50) and to compare the functional status data of pediatric SB patients with those of healthy children. Material and Methods: Forty children with SB and 40 healthy children aged between 36 and 143 months were enrolled in the study. Both pediatric SB patients and healthy children were divided into three age groups: Group 1: 36-71 months, Group 2: 72-107 months, and Group 3: 108-143 months. The WeeFIM and CHQPF-50 were completed for children with SB, whereas the WeeFIM was completed only for healthy children. Results: In both assessments, the total score and subscale scores were lower than normal values in children with SB. However, improvement was found in self-care; communication; social, emotional, and mental status; and family factors with increasing age. On the other hand, there was no improvement in physical score, transfer, mobility, and sphincter control with increasing age. Functional status of children with SB was significantly lower compared to healthy children. Conclusion: There was progress in self-care, communication, family factors, and social, emotional and mental status in children with SB with increasing age.

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“…age, mobility, neurological status, diet, etc). Thus, the 'successful bowel continence program' is a dynamic process, not a one-time prescription (6).…”

Section: Introductionmentioning

confidence: 99%

“…Areas for assessment in bowel continence Several time per day, every day, once a week Based on expected, approximate length of sigmoid-rectal segment of colon. Less than expected volumes suggest an incomplete evacuation and tendency for impaction with incontinent "smears"(2,6) …”

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confidence: 99%

Decision-Making for a Successful Bowel Continence Program

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Bowel continence is one of the most difficult challenges for patients with spina bifida. Incontinence acts as a social stigma for children and a barrier for adults seeking employment. We present an algorithm for stepwise decision-making in construction of personalized continence programs for greater likelihood of success. The protocol contains 13 assessment points including; stool consistency, frequency and amount; mobility; level of paraplegia: diet; medication; anal/rectal canal tone; prior programs attempted; family routines; age; accessibility; and learning issues. Based on outcomes of these assessments, an individualized bowel program is constructed. The algorithm helps the practitioner and patient decide on components and indicators of a successful continence program. The recommended program might include timed toileting, suppository, continence enema, and ACE procedure, or a combination. Evaluation and patient education address adequate fluid/fiber, appropriate toileting equipment, and use of stool softeners/laxatives. Descriptions are available. Key elements in monitoring a continuing plan for continence include: the degree of constipation and its etiology; changing age; family availability for assistance until interdependence is optimal; wheelchair accessibility of the toilet; and ability to transfer to and from the toilet. Use of the algorithm allows for careful decision-making based on information from the patient and family. This has led to greater success in bowel continence in children with spina bifida.

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A Systematic Approach to Bowel Continence for Children with Spina Bifida

Cited by 9 publications

References 0 publications

Colon Enemas for Fecal Incontinence in Patients with Spina Bifida

Colon Enemas for Fecal Incontinence in Patients with Spina Bifida

Assessment of Functional Status and Quality of Life in Children with Spina Bifida

Decision-Making for a Successful Bowel Continence Program

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