Koppen Ilan J N, Kuizenga-Wessel Sophie, Voogt Heleen W, Voskeuil Marijke E, Benninga Marc A
*Department of Pediatric Gastroenterology and Nutrition †Department of Pediatric Surgery, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
J Pediatr Gastroenterol Nutr. 2017 Feb;64(2):225-229. doi: 10.1097/MPG.0000000000001236.
The aim of the study was to assess the treatment efficacy of transanal irrigation and parental satisfaction in children with intractable functional constipation (FC) treated with Peristeen.
Cross-sectional survey study among parents of children (age 0-18 years) treated with Peristeen for FC (based on the Rome III criteria). Anonymous questionnaires were sent out to parents via mail, these consisted of 25 self-developed, multiple-choice questions regarding the use of Peristeen, current gastrointestinal symptoms, adverse effects of Peristeen, concomitant medication use, and parental satisfaction.
Out of 91 invited families, 67 (74%) returned the questionnaire. In total, 84% of patients experienced fecal incontinence prior to treatment. Out of all children who still used Peristeen at the time of survey (n = 49), fecal incontinence had resolved completely in 41%, 12% experienced occasional episodes of fecal incontinence (<1 episode per week) and the remaining 47% still experienced episodes of fecal incontinence regularly (≥1 time per week). A total of 28 children (42%) experienced pain during rectal irrigation, especially during insertion of the catheter, inflating the balloon, or during irrigation. Overall, 86% of the parents were satisfied with the result of transanal irrigation and 67% reported that they would continue using transanal irrigation for the treatment of their child's symptoms.
Transanal irrigation may be effective in the treatment of children with FC and renders a high parental satisfaction. Future prospective studies, preferably RCTs, are necessary to further evaluate this treatment option.
本研究旨在评估经肛门灌洗对难治性功能性便秘（FC）患儿的治疗效果以及家长满意度，这些患儿采用佩里斯汀（Peristeen）进行治疗。
对符合罗马III标准、采用佩里斯汀治疗FC的0至18岁患儿家长进行横断面调查研究。通过邮件向家长发放匿名问卷，问卷包含25个自行设计的多项选择题，内容涉及佩里斯汀的使用情况、当前胃肠道症状、佩里斯汀的不良反应、伴随用药情况以及家长满意度。
在91个受邀家庭中，67个（74%）回复了问卷。总体而言，84%的患者在治疗前存在大便失禁情况。在调查时仍在使用佩里斯汀的所有患儿（n = 49）中，41%的患儿大便失禁已完全缓解，12%的患儿偶尔出现大便失禁情况（每周<1次），其余47%的患儿仍经常出现大便失禁情况（每周≥1次）。共有28名患儿（42%）在直肠灌洗过程中感到疼痛，尤其是在插入导管、充盈气囊或灌洗过程中。总体而言，86%的家长对经肛门灌洗的效果感到满意，67%的家长表示他们会继续使用经肛门灌洗来治疗孩子的症状。
经肛门灌洗可能对FC患儿有效，并使家长满意度较高。未来有必要进行前瞻性研究，最好是随机对照试验，以进一步评估这种治疗选择。
