title: Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation.
abstract: OBJECTIVE
  To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation (RCI) in patients with fecal incontinence or constipation.
  
  
  METHODS
  Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire.
  
  
  RESULTS
  Of the 201 patients (93 adults, 108 children), 101 (50%) responded. Adults: anal plugs (8), five stopped immediately, one stopped after 20 mo and two used it for 12-15 mo. RCI (40, 28 fecal incontinence, 12 constipation), 63% are still using it (mean 8.5 years), 88% was satisfied. Younger adults (< 40 years) were more satisfied with RCI (94% vs 65%, P = 0.05). Children: anal plugs (7), 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI (26 fecal incontinence, 22 constipation), 90% are still using it (mean time 6.8 years) and felt satisfied. Children tend to be more satisfied (P = 0.001). Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation.
  
  
  CONCLUSIONS
  RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.
authors.affiliation: Department of Gastro-enterology and Hepatology, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands. m.cazemier@vumc.nl
authors.forename: Marcel
authors.initials: M
authors.lastname: Cazemier
authors.forename: Richelle-Jf
authors.initials: RJ
authors.lastname: Felt-Bersma
authors.forename: Chris-Jj
authors.initials: CJ
authors.lastname: Mulder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000628:therapy*; D005240:Feasibility Studies; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D013630:Tampons, Surgical; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome