Ten-Year Experience Using Antegrade Enemas in Children

Mugie, Suzanne M.; Machado, Rodrigo Strehl; Mousa, Hayat; Punati, Jaya; Hogan, Mark; Benninga, Marc A.; Lorenzo, Carlo Di

doi:10.1016/j.jpeds.2012.04.042

Cited by 53 publications

(45 citation statements)

References 25 publications

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“…Commonly seen complications include granulation tissues around stoma, leakage, and minor infections. Major complications such as fistulae, peritonitis, and stenosis of the stoma are only seen in a minority 104 . Other surgical procedures such as sigmoid resection, colorectal resection, subtotal colectomy, and proctocolectomy with ileo-anal anastomosis are only reserved for children with intractable constipation who failed to respond to all other therapeutic modalities 105 .…”

Section: Life Style Modificationsmentioning

confidence: 99%

Constipation in children: From misty to understanding

Rajindrajith

2014

Sri Lanka J Child Health

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Section: Life Style Modificationsmentioning

confidence: 99%

Constipation in children: From misty to understanding

Rajindrajith

2014

Sri Lanka J Child Health

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“…Success rates using the antegrade continence enema have varied between 59 and 97% [33,46,47,51,[54][55][56]. Variability in success rates may be attributed to the length in follow-up and possible decreased effectiveness of the ACE over time.…”

Section: Antegrade Colonic Enemasmentioning

confidence: 99%

“…Siddiqui et al reported 93% initial success rate; however, 64% of patients developed subsequent relapse with mean time to first relapse of~88 months [33]. A recent 10-year experience in their pediatric population, Mugie et al reported an overall full and partial success rate of 91% and 7%, respectively, failure rate attributed to ineffective colonic washouts [54].…”

Section: Antegrade Colonic Enemasmentioning

confidence: 99%

“…Failure rates vary between 7 and 31% [33,54,[57][58][59]. Failures have been mainly secondary to complications, ineffective washouts and poor compliance.…”

Section: Antegrade Colonic Enemasmentioning

confidence: 99%

“…Failures have been mainly secondary to complications, ineffective washouts and poor compliance. Increased failure rates have been reported in the younger age group, patients with ARMs [54,60], female sex and prolonged colonic transit time [59], abnormal colonic motility [54] and in those with history of Hirschsprung's disease and cerebral palsy [54].…”

Section: Antegrade Colonic Enemasmentioning

confidence: 99%

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Review of organic causes of fecal incontinence in children: evaluation and treatment

Ambartsumyan

Nurko

2013

Expert Review of Gastroenterology & Hepatology

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Even though fecal incontinence (FI) in children is most commonly the result of functional constipation, there are organic conditions that can be associated with incontinence. FI has a major impact on the quality of life of those children who experience it. The general objectives of any bowel program are to achieve predictability and independence. This is achieved by manipulating colonic transit and stool consistency and by producing more controlled evacuations, usually with the use of rectal interventions. Dietary interventions and medications can be used to change stool consistency or to manipulate transit by accelerating or slowing it down. Biofeedback or other interventions that increase sphincter pressure can also be used to improve anorectal function. Enemas or suppositories can be used to empty the sigmoid colon in a more controlled manner. With the recent advent of the antegrade colonic enemas, the patient can have predictable bowel movements and become independent.

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Transanal irrigation in children with functional constipation: A systematic review and meta‐analysis

Bolia,

Goel,

Thapar

2024

J. pediatr. gastroenterol. nutr.

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ObjectivesRefractory functional constipation is a challenging condition to manage in children. The use of transanal irrigation (TAI) is well reported in children with neurological disorders as well as anorectal malformations but less so in children with functional disorders of defecation. The objective of our study was to evaluate the effectiveness, safety and outcomes of TAI in children with functional constipation.MethodsPubMed, Scopus and Google Scholar were searched for publications related to the use of TAI in functional constipation. Data regarding the study design, sample size, patient characteristics, investigator‐reported response to TAI and adverse effects were extracted from studies that met the selection criteria. The inverse variance heterogeneity model was used for ascertaining the summary effect in this meta‐analysis.ResultsThe search strategy yielded 279 articles of which five studies were included in the final review. The studies were from the United Kingdom (n = 2), Netherlands (n = 2) and Denmark (n = 1). These studies included 192 children with a median age ranging from 7 to 12.2 years old. The TAI systems used in these studies were: Peristeen (n = 2), Peristeen or Qufora (n = 1), Alterna (n = 1) and Navina (n = 1). The follow‐up duration ranged from 5.5 months to 3 years. Eleven (5.7%) children did not tolerate TAI and withdrew from treatment soon after initiation. The pooled investigator‐reported success of TAI was 62% (95% CI: 52%–71%). The most common adverse event was pain which was experienced by 21.7% of children. A total of 27 (14%) were successfully weaned off TAI at the last follow‐up.ConclusionsTAI is reported to be successful in 62% of children with refractory functional constipation. There is a need for well‐designed prospective trials to evaluate this treatment option in children with refractory functional constipation.

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Ten-Year Experience Using Antegrade Enemas in Children

Cited by 53 publications

References 25 publications

Constipation in children: From misty to understanding

Constipation in children: From misty to understanding

Review of organic causes of fecal incontinence in children: evaluation and treatment

Transanal irrigation in children with functional constipation: A systematic review and meta‐analysis

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