OBJECTIVES

Neurogenic Bowel Dysfunction (NBD) is colorectal dysfunction due to absence of nervous control. Common causes of NBD in a pediatric population include spinal cord injuries (SCI) and spina bifida (SB). These patients experience chronic fecal incontinence and constipation, with accompanying increased use of health care services. Objective of this study is to investigate the impact of transanal irrigation treatment (TAI) for fecal incontinence and constipation on bowel management (BM) and healthcare utilization among pediatric patients with NBD.

METHODS

Parents of children with NBD with an e-mail address available in a database maintained by Coloplast Corp were invited to access an online survey about emergency room (ER) visits, hospital admissions (HL), and experiences in BM pre and post treatment with TAI. Survey responses requiring more than 2 years of recall were excluded from the analysis. For non-continuous outcomes, McNemar's Test was used to assess differences in proportions pre and post treatment; for continuous outcomes with non-normal distribution, the signed rank test was used. Statistical significance was determined at p<0.05.

RESULTS

32 responses were included in analysis. 72% were <12 years old and 28% were [12-21) years old. 81% had spina bifida; 19% had other conditions. 56% were male. Percent of patients who had ER visits within six months before TAI was 13% and after TAI was 6% (p=0.625); percent with HL was 26% before and 6% after (p=0.0313). Median time per week spent on bowel management was 6 hours before; and 3.5 hours after (p<.0001). Percent of children requiring BM supplies (e.g., diaper, incontinence pad) was 91% before and 63% after TAI (p=0.0039). 75% parents reported they were very satisfied with TAI; 72% reported TAI was very easy to use.

CONCLUSIONS

For children with NBD, TAI was associated with significant reductions in HL, weekly hours required for BM and use of BM supplies.