Aim:To evaluate the outcome of transrectal irrigation(TRI)using clean tap water without salt in children with myelomeningocele and neurogenic bowel problems.Methods:40 children(21 boys and 19 girls;aged 10 mo to 11 y)...Aim:To evaluate the outcome of transrectal irrigation(TRI)using clean tap water without salt in children with myelomeningocele and neurogenic bowel problems.Methods:40 children(21 boys and 19 girls;aged 10 mo to 11 y)with myelomeningocele and neurogenic bowel dysfunction were treated with TRI given by a stoma cone irrigation set daily or every second day.A questionnaire on the effects on faecal incontinence,constipation and self-management was completed by the parents,4 mo-8 y(median 1.5 y)after start.Effects on rectal volume,anal sphincter pressure and plasma sodium were evaluated before and after the start of irrigation.Results:At follow-up,35 children remained on TRI,four had received appendicostomy,while one defecated normally.For all children but five(35/40;85%)the procedure worked satisfactorily,but a majority found the procedur every time consuming and only one child was able to perform it independently.All children were free of constipation;most(35/40)were also anal continent.Rectal volume and anal sphincter pressure improved,while plasma sodium values remained within the normal range.Conclusion:Transrectal irrigation with tap water is a safe method to resolve constipation and faecal incontinence in children with myelomeningocele and neurogenic bowel dysfunction,but it does not help children to independence at the toilet.展开更多
文摘Aim:To evaluate the outcome of transrectal irrigation(TRI)using clean tap water without salt in children with myelomeningocele and neurogenic bowel problems.Methods:40 children(21 boys and 19 girls;aged 10 mo to 11 y)with myelomeningocele and neurogenic bowel dysfunction were treated with TRI given by a stoma cone irrigation set daily or every second day.A questionnaire on the effects on faecal incontinence,constipation and self-management was completed by the parents,4 mo-8 y(median 1.5 y)after start.Effects on rectal volume,anal sphincter pressure and plasma sodium were evaluated before and after the start of irrigation.Results:At follow-up,35 children remained on TRI,four had received appendicostomy,while one defecated normally.For all children but five(35/40;85%)the procedure worked satisfactorily,but a majority found the procedur every time consuming and only one child was able to perform it independently.All children were free of constipation;most(35/40)were also anal continent.Rectal volume and anal sphincter pressure improved,while plasma sodium values remained within the normal range.Conclusion:Transrectal irrigation with tap water is a safe method to resolve constipation and faecal incontinence in children with myelomeningocele and neurogenic bowel dysfunction,but it does not help children to independence at the toilet.
