title: Colon enemas for fecal incontinence in patients with spina bifida.
abstract: OBJECTIVE
  We studied the use of colon enemas in achieving fecal pseudocontinence in patients with spina bifida to define the variables associated with success.
  
  
  METHODS
  Questionnaires were individually filled out by all patients with spina bifida using colon enemas at our Spina Bifida Reference Center between October 2009 and June 2010. Patient age, type of enema, volume required, evacuation time, followup, continence and independence were recorded. Fecal pseudocontinence was defined as no involuntary stool loss during the last 6 months. Social continence was defined as involuntary stool loss less than once monthly. Children are routinely seen at the reference center, while adults are seen on request.
  
  
  RESULTS
  A total of 25 children and 15 adults with spina bifida were studied. Median volume required was 1 liter (range 0.5 to 2) in children and 1.5 liters (0.75 to 3) in adults. Median evacuation time was 30 minutes (range 15 to 60) in children and 60 minutes (30 to 120) in adults. Fecal continence was achieved in 76% of children (19 of 25) and 60% of adults (9 of 15), and social continence in 88% of children (23 of 25) and 67% of adults (10 of 15). A significant relation was found between medical followup since childhood and fecal pseudocontinence. No enema determinants predicted pseudocontinence.
  
  
  CONCLUSIONS
  Colon enemas are a valuable method in achieving continence. At our center medical followup from childhood to adulthood is associated with successful acquisition of fecal pseudocontinence.
authors.affiliation: Department of Paediatric Gastroenterology, University Hospital Ghent, Ghent, Belgium. Saskia.vandevelde@ugent.be
authors.forename: S
authors.initials: S
authors.lastname: Vande Velde
authors.forename: S
authors.initials: S
authors.lastname: Van Biervliet
authors.forename: E
authors.initials: E
authors.lastname: Van Laecke
authors.forename: R
authors.initials: R
authors.lastname: De Bruyne
authors.forename: H
authors.initials: H
authors.lastname: Verhelst
authors.forename: P
authors.initials: P
authors.lastname: Hoebeke
authors.forename: M
authors.initials: M
authors.lastname: Van Winckel
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003106:Colon; D004733:Enema; D005242:Fecal Incontinence / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D016135:Spinal Dysraphism / Q000150:complications*; D055815:Young Adult