Bernard-Bonnin A C, Haley N, Bélanger S, Nadeau D
Department of Pediatrics, University of Montréal, Queébec, Canada.
J Dev Behav Pediatr. 1993 Dec;14(6):397-400.
Treatment of encopresis in childhood is often a long and trying process. Children followed for secondary encopresis in a multidisciplinary clinic between 1984 and 1989 were sent a parent/child mail questionnaire seeking information on their understanding of encopresis as well as their opinions on current treatment modalities. Twenty-eight families responded (20 boys and 8 girls), the child's mean age was 9.8 years, and the mean time elapsed after diagnosis was 3.5 years. Parents and children reported that intestinal dysfunction (53%) and painful defecation (46%) were the most important causes of their encopresis. Treatment modalities including enemas were well accepted by both parents and children, with parents considering dietary changes the most useful treatment modality (p < .01). Children reported that regular "toilet routine" was the most helpful in reestablishing continence. Despite good comprehension of the problem and acceptance of the treatment modalities, the complete recovery rate after 3.5 years was only 35.7%, with no differences noted between responders and nonresponders. Encopresis is a chronic condition that persists in a significant proportion of patients, despite adequate patient and parental knowledge and patient acceptance of treatment.
儿童大便失禁的治疗通常是一个漫长且艰难的过程。1984年至1989年间，在一家多学科诊所接受继发性大便失禁治疗随访的儿童，收到了一份家长/儿童邮件调查问卷，以了解他们对大便失禁的理解以及对当前治疗方式的看法。28个家庭回复了问卷（20名男孩和8名女孩），孩子的平均年龄为9.8岁，诊断后的平均时间为3.5年。家长和孩子报告称，肠道功能障碍（53%）和排便疼痛（46%）是他们大便失禁的最重要原因。包括灌肠在内的治疗方式得到了家长和孩子的广泛接受，家长认为饮食改变是最有用的治疗方式（p < 0.01）。孩子报告称，规律的“如厕习惯”对恢复自控能力最有帮助。尽管对问题有很好的理解且接受治疗方式，但3.5年后的完全康复率仅为35.7%，应答者和非应答者之间没有差异。大便失禁是一种慢性病，尽管患者和家长有足够的了解且患者接受治疗，但仍有相当比例的患者持续存在该问题。
