Transanal irrigation is effective in functional fecal incontinence
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Functional fecal incontinence (FFI) is divided into cases related to functional constipation (FC) and cases without concomitant constipation termed functional non-retentive fecal incontinence (FNRFI). Transanal irrigation (TAI) is widely used in children with neurogenic fecal incontinence but is less studied in children with functional defecation disorders. The aim was to evaluate the feasibility and efficacy of TAI in the treatment of FFI. A retrospective study in 72 children (mean age 9.2 ± 2.2 years, 47 males) with treatment-resistant FFI was performed. All children accepted treatment and 35% (n = 25) were titrated to daily sessions. Of the 63 children who fulfilled the Rome III criteria of constipation, 46 (73%) showed full response with complete remission of incontinence episodes. Eleven (17%) showed partial response (≥50% reduction). Of nine children with FNRFI, four (44%) showed full response whereas two (22%) showed partial response. We found no significant difference in the reduction of incontinence episodes between the children with FC (87%) and children with FNRFI (68%) (p = 0.11).
What is Known:
• Functional fecal incontinence (FFI) is a frequent, chronic condition with significant impact on children’s quality of life.
• Transanal irrigation (TAI) is used in children with neurogenic bowel dysfunction but less studied in children with functional defecation disorders.
What is New:
• TAI seems an effective, well-tolerated, and safe choice in children with FFI due to functional constipation.
• Albeit the number of children with functional non-retentive fecal incontinence was low in our study, TAI seems effective also in this group of children.
KeywordsFunctional fecal incontinence Functional constipation Functional non-retentive fecal incontinence Transanal irrigation Children
Antegrade continence enema
The International Children’s Continence Society
Functional non-retentive fecal incontinence
Functional fecal incontinence
Cecilie Siggaard Jørgensen—contribution: study design, data collection, data analysis, and writing the first draft. Konstantinos Kamperis—contribution: study design, data analysis, and critical revision of manuscript. Line Modin—contribution: study design, and critical revision of manuscript. Charlotte Siggaard Rittig—contribution: study design, and critical revision of manuscript. Søren Rittig—contribution: study design, data analysis, and critical revision of manuscript.
Compliance with ethical standards
The project was preformed according to the regulations of The Central Denmark Region Committees on Health Research Ethics. For this type of study, formal consent is not required.
Conflict of interest
The authors declare that they have no conflict of interest.
No grants or financial support has been received.
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