Comparing quality of life improvement after antegrade continence enema (ACE) therapy for patients with organic and functional constipation / encopresis

Shawn Brophy, Kelly Brennan, Emily Woodgate, Bridget Pinaud, Elizabeth McLaughlin, Joanne Gillespie, Zubin Grover, Christopher Blackmore, Rodrigo LP Romao

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background: We compared patient- and family-reported overall and stool-related quality of life (QoL) before and after an antegrade continence enema (ACE) procedure (cecostomy tube insertion) for refractory chronic constipation or fecal incontinence (CCFI). We hypothesized that patients with functional diagnoses experience similar improvements in QoL compared to those with organic diagnoses. Methods: This is a cross-sectional study of patients undergoing cecostomy tube insertion for CCFI at a tertiary pediatric hospital from 2012 to 2019. Patients and/or primary caregivers completed validated stooling and overall QoL surveys based on three time points: before surgery, three months after surgery, and at the time of survey / date of last follow-up. Repeated measures analyses compared scores over time between subjects and within the diagnostic groups. Results: The response rate was 65% (22/34 patients, 12 organic and 10 functional diagnoses). Mean age was 8.3 years and 32% of the participants were female. Organic diagnoses were: spina bifida (6), anorectal malformation (5), and Hirschsprung Disease (1). There was substantial improvement in stool-related and overall QoL at three months post-ACE procedure (both p<0.001) for all patients; both scores continued to improve significantly until the date of last follow-up (median 4.1 years, IQR 2.3–5.6, p<0.001). There was no statistically significant difference in scores between patients with organic and functional diagnoses. Conclusions: Caregivers perceive a significant, sustainable improvement in stooling habits and QoL following ACE therapy. The improvement is comparable between patients with a functional diagnosis and those with an underlying organic reason for their CCFI.

Original languageEnglish
Pages (from-to)855-860
Number of pages6
JournalJournal of Pediatric Surgery
Volume57
Issue number5
DOIs
Publication statusPublished - May 2022

Bibliographical note

Publisher Copyright:
© 2022

ASJC Scopus Subject Areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

PubMed: MeSH publication types

  • Journal Article

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