Colorectal dysfunction and faecal incontinence in children with spina bifida.
OBJECTIVE
To quantify colorectal neurogenic dysfunction in children with spina bifida and to evaluate the clinical efficacy of appropriate rehabilitation performed by the coloproctologist in the spina bifida team.


METHODS
The bowel function of 73 patients with congenital (67) and acquired (six) spinal lesions (age 7-25 years) was evaluated by one physician. Evacuation habit was classified as full bowel control, mild and severe constipation or incontinence. Fifty-two children had mild or severe incontinence or constipation, 22 of whom were treated by the coloproctologist using biofeedback or conventional therapy; 30 were not treated. The outcome was compared between the groups


RESULTS
Bowel constipation remained stable in 90% and was complicated in 10% of the untreated patients, while it ameliorated in 59% of patients who received specialist treatment.


CONCLUSIONS
Neurogenic bowel dysfunction needs specialist management to achieve better results, using the concept of controlled incontinence. There was no significant difference between conventional therapy and biofeedback methods.
Ponticelli
A
A
Paediatric Surgery Division, Spina Bifida Centre, Bambino Gesu Children's Hospital, Palidoro, Rome, Italy.
Iacobelli
B D
BD
Silveri
M
M
Broggi
G
G
Rivosecchi
M
M
De Gennaro
M
M
D000293:Adolescent; D000328:Adult; D001676:Biofeedback, Psychology; D002648:Child; D003108:Colonic Diseases / Q000209:etiology* / Q000534:rehabilitation; D003248:Constipation / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology* / Q000534:rehabilitation; D006801:Humans; D016135:Spinal Dysraphism / Q000150:complications* / Q000534:rehabilitation; D016896:Treatment Outcome