title: Functional nonretentive fecal incontinence: do enemas help?
abstract: OBJECTIVE
  To assess the current treatment of functional nonretentive fecal incontinence, which consists of education, toilet training, and positive motivation.
  
  
  METHODS
  Patients, age 6 years and older, referred for fecal incontinence (FI) and diagnosed with functional nonretentive fecal incontinence were eligible candidates. Seventy-one children (76% boys, median age 9.3 years) were randomized to receive conventional therapy (control group) or conventional therapy in addition to daily enemas during 2 weeks. Treatment success was defined as <2 episodes of FI/month without use of enemas.
  
  
  RESULTS
  At intake, the median FI frequency was 6.1 per week, whereas the median defecation frequency was 7.0 per week. At the end of the treatment period, the median number of FI episodes was significantly decreased in both groups: from 7.0 (IQR 4.0-11.5) to 1.0 (IQR 0.5-2.0) in the intervention group and from 6.0 (IQR 4.0-10) to 2.0 (IQR 0.5-3.5) in the control group. No statistical difference was found between the groups at the end of the treatment period (P = .08) nor during additional follow-up (average success rate 17% for both groups, P = .99).
  
  
  CONCLUSIONS
  Temporarily application of additional rectal enemas did not significantly improve treatment success compared with conventional therapy alone.
authors.affiliation: Department of Pediatrics, Emma Children's Hospital, Amsterdam Medical Center, Amsterdam, The Netherlands. r.e.burgers@amc.nl
authors.forename: Rosa
authors.initials: R
authors.lastname: Burgers
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Reitsma
authors.forename: Marloes E J
authors.initials: ME
authors.lastname: Bongers
authors.forename: Fleur
authors.initials: F
authors.lastname: de Lorijn
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
mesh_terms: D002648:Child; D003672:Defecation / Q000187:drug effects*; D004733:Enema / Q000009:adverse effects / Q000379:methods*; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D016896:Treatment Outcome