title: Impact of the Bowel Management Program on the quality of life in children with fecal incontinence.
abstract: OBJECTIVE
  Evaluate the impact of implementing Bowel Management Program (BMP) on quality of life (QoL) in children with fecal incontinence (FI).
  
  
  METHODS
  Children 3-12 years referred to the Children's Treatment Center of FI were included and categorized accordingto the tendency to constipation (dilated colon; group 1) or diarrhea (non-dilated colon; group 2). Evaluations were performed before and after 3 months of BMP implementation. Perceptions from parents and children about QoL were assessed by the instrument PedsQL4.0 and the severity of FI by the fecal incontinence index (FII) of Wexner scale.
  
  
  RESULTS
  43 children (mean age of 7.7 ± 3.1) were studied. 32 (74.4 %) belonged to group 1 and 11 (25.6 %) to group 2. After 3 months of BMP, it was noticed a significant improvement of the FII (14.5 ± 3.7 versus 2.8 ± 2.5; p < 0.001) in both groups. QoL perception by the parents and children increased on PedsQL4.0 evaluation (p < 0.001). There was a medium inverse statistically significant correlation of the FII and the total PedsQL4.0 score among children and parents (r = -0.47, p = 0.009 and r = -0, 39, p = 0.03, respectively).
  
  
  CONCLUSIONS
  The BMP applied by a multidisciplinary dedicated team significantly improves the QoL of children with FI in the short-term period.
authors.affiliation: Pediatric Surgery Section, Albert Sabin Pediatric Hospital (HIAS), Tertuliano Sales, 544-Vila União, Fortaleza, Ceará, CEP: 60430-230, Brazil. jhfcolares@hotmail.com.
authors.forename: João H F
authors.identifier: http://orcid.org/0000-0002-9138-2053
authors.initials: JH
authors.lastname: Colares
authors.affiliation: Nursing Department, Albert Sabin Pediatric Hospital (HIAS), Fortaleza, Ceará, Brazil.
authors.forename: Marionescu
authors.initials: M
authors.lastname: Purcaru
authors.affiliation: University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil.
authors.forename: Guilherme P F
authors.initials: GP
authors.lastname: da Silva
authors.affiliation: Master's Department in Public Health, University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil.
authors.forename: Mirna A
authors.initials: MA
authors.lastname: Frota
authors.affiliation: Master's Department in Public Health, University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil.
authors.forename: Carlos A B
authors.initials: CA
authors.lastname: da Silva
authors.affiliation: Pediatric Surgery Section, Albert Sabin Pediatric Hospital (HIAS), Tertuliano Sales, 544-Vila União, Fortaleza, Ceará, CEP: 60430-230, Brazil.|Department of Surgery, Medical School, Federal University of Ceará (UFC), Fortaleza, Ceará, Brazil.
authors.forename: Antônio A
authors.initials: AA
authors.lastname: Melo-Filho
authors.affiliation: Division of Pediatric Surgery, Colorectal Center for Children, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bischoff
authors.affiliation: Division of Pediatric Surgery, Colorectal Center for Children, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Peña
mesh_terms: D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003248:Constipation / Q000209:etiology / Q000628:therapy; D003967:Diarrhea / Q000209:etiology / Q000628:therapy; D004733:Enema / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010348:Patient Care Team; D010353:Patient Education as Topic; D011788:Quality of Life
keywords: Bowel management; Children; Fecal incontinence; Quality of life; Treatment