In the United States, about 5% of children suffer from persistent fecal incontinence. Unfortunately, traditional medical treatment for fecal incontinence fails in 20% to 60% of patients. In these situations, a combination medical-behavioral paradigm was frequently advocated. For a pilot study, researchers wanted to describe an interdisciplinary group-based treatment for fecal incontinence in school-aged children, as well as to show how variations in treatment adherence rates impact clinical success. The poop group used a developmentally appropriate care paradigm in which caregivers and children attended separate yet concurrent treatment sessions. Pre- through post-treatment, this multidisciplinary 6-week program was aimed to promote proper stooling, minimize soiling incidents, and improve medication adherence. The GI system, medicine, toilet sitting posture, water, fiber, and behavior contracts were all covered in group sessions. In addition, at each session, participant families met privately with an Advanced Nurse Practitioner to review symptoms and make medication changes as required.
The 6-week regimen was completed by 19 families. Stool frequency was increased (P<0.01), and soiling was decreased (P<0.00). Adherence to medication was also enhanced (P<0.04). At the one-month follow-up, the treatment results were consistent. Therapeutic effectiveness was most likely due to a developmentally focused intervention and an interdisciplinary treatment approach.
For families of children who have failed regular outpatient therapy, a poop group may be a useful multidisciplinary therapeutic alternative.
Reference:journals.lww.com/jpgn/Fulltext/2019/09000/Group_Treatment_of_Fecal_Incontinence__A.8.aspx
