Hougaard Nicklas B, Andersen Rene F, Kamperis Konstantinos, Jørgensen Cecilie S
Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, 8200, Aarhus N, Denmark.
Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus N, Denmark.
Int J Colorectal Dis. 2025 Jan 30;40(1):29. doi: 10.1007/s00384-025-04813-0.
Functional faecal incontinence (FFI) is a stigmatising condition for a child and parents and can be a challenge to treat even in tertiary centres. Transanal irrigation (TAI) is an emerging treatment with great success in refractory cases. We performed TAI with a substantially decreased amount of water used (low-volume TAI), yet no previous evidence exists on this treatment in children. We conducted this study to evaluate the efficacy of low-volume TAI in reducing faecal incontinence (FI) episodes and to provide associated factors for response.
Children with FFI trained in low-volume TAI in our outpatient incontinence clinic were identified. Baseline characteristics along with rectal ultrasound examination, information on weekly FI episodes and concomitant use of laxatives were noted. The continence status of patients was registered at the first outpatient clinic appointment after the commencement of TAI and after 6 months of treatment. During this period, information about side effects and changes in medication were captured.
We identified 47 children (mean age 8.06 ± 2.08 years, 27 males) treated with low-volume TAI. Thirty-five (74%) were diagnosed with functional constipation and FI, while 12 (26%) suffered from non-retentive faecal incontinence. Twenty (42%) children gained full faecal continence after 6.75 ± 0.3 months. We found no differences between responders and non-responders in baseline characteristics.
Low-volume TAI appears safe and effective in the treatment of FFI refractory to first-line treatment in children. Low-volume TAI could be a valuable tool for the management of these children as the treatment is less invasive, low in cost and well accepted.
功能性大便失禁（FFI）对儿童及其父母来说是一种令人感到羞耻的病症，即使在三级医疗中心进行治疗也可能具有挑战性。经肛门冲洗（TAI）是一种新兴的治疗方法，在难治性病例中取得了巨大成功。我们进行了用水量大幅减少的TAI（低容量TAI），但此前尚无关于该治疗方法在儿童中的证据。我们开展这项研究以评估低容量TAI在减少大便失禁（FI）发作方面的疗效，并提供反应的相关因素。
确定在我们门诊失禁诊所接受低容量TAI训练的FFI儿童。记录基线特征以及直肠超声检查结果、每周FI发作的信息和泻药的使用情况。在TAI开始后的首次门诊预约时以及治疗6个月后记录患者的控便状态。在此期间，收集有关副作用和药物变化的信息。
我们确定了47名接受低容量TAI治疗的儿童（平均年龄8.06±2.08岁，27名男性）。35名（74%）被诊断为功能性便秘和FI，而12名（26%）患有非潴留性大便失禁。20名（42%）儿童在6.75±0.3个月后实现了完全控便。我们发现反应者和无反应者在基线特征方面没有差异。
低容量TAI在治疗儿童一线治疗难治的FFI方面似乎安全有效。低容量TAI可能是管理这些儿童的一种有价值的工具，因为该治疗侵入性较小、成本低且易于接受。
