Toilet Training in Children and Adolescents with Down Syndrome

Dreher, Taylor; Wolter‐Warmerdam, Kristine; Holland, Samantha; Katz, Terry; Patel, Lina

doi:10.1097/dbp.0000000000001058

Cited by 2 publications

(2 citation statements)

References 25 publications

(40 reference statements)

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“…These results being similar to this study, it is important to consider whether it is explained by the fecal continence age being higher in patients with DS and patients with cognitive impairment or if the association with HD worsens the outcomes. According to Mrad et al in 2018 and Dreher et al in 2022, patients with DS without HD are completing toilet training somewhere between 4.7 and 6.6 years old in comparison to 2.3–3.4 years in neurotypical children, which could possibly be proportional to the numbers in our study (14,15). On the other hand, in 2017, Niemczyk et al (16) showed that fecal incontinence in DS patients aged 4–12 years old was approximately 40.8% compared to 81.8% at 5 years in our study and 60% at 10 years, implying that the association with HD could actually makes it worse.…”

Section: Discussionsupporting

confidence: 49%

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Short and Long-Term Outcomes in Hirschsprung Disease: Are the Syndrome-Associated Patients Really Doing Worse?

Gagnon

Duguay

Prasil

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Introduction: Given the lack of data to help caregivers in the follow-up of Hirschsprung disease (HD), this study aimed to compare the functional outcomes of isolated Hirschsprung disease (I-HD) to syndrome-associated Hirschsprung disease (SA-HD) at 1, 3, 5, and 10 years. Methods: A retrospective chart review of patients diagnosed with HD between January 1990 and May 2021 at our pediatric center was performed to collect data on patient characteristics, investigations, and treatments. Ninety-five patients were identified, of whom 76 were included in the study. SA-HD is defined as a syndrome known to be associated with HD or cognitive impairment. Results: Patient characteristics were comparable between groups (P > 0.05). There were 52 patients with I-HD and 24 with SA-HD. The patients median age was 9 days at diagnosis and 1.5 month at surgery. SA-HD patients became bowel continent at a significantly older age (mean age 8.43 vs 4.94 years, P = 0.0471) and received more bowel continence medications. At 5 years, SA-HD patients requiring ≥2 medications for bowel continence represented 54.5% versus 11.1% of I-HD patients (P = 0.009). Lastly, SA-HD patients had urinary incontinence at a significantly older age (P = 0.0136, 5 years). Conclusion: Clinicians should be aware that SA-HD patients are more prone to bladder dysfunction and became bowel continent at an older age than I-HD patients. They need more and prolonged bowel management medications, and other important complications need to be addressed in patient care. These results should prompt a longer follow-up period for these patients, especially in SA-HD.

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Section: Discussionsupporting

confidence: 49%

“…our study (14,15). On the other hand, in 2017, Niemczyk et al (16) showed that fecal incontinence in DS patients aged 4-12 years old was approximately 40.8% compared to 81.8% at 5 years in our study and 60% at 10 years, implying that the association with HD could actually makes it worse.…”

Section: Discussioncontrasting

confidence: 40%