The following is a summary of “Long-Term Outcomes of Antegrade Continence Enemas to Treat Constipation and Fecal Incontinence in Children,” published in the August 2023 issue of Pediatrics by Baaleman, et al.
For a prospective cohort study, researchers sought to investigate the long-term outcomes of antegrade continence enema (ACE) treatment in children with constipation or fecal incontinence.
Pediatric patients with organic or functional defecation disorders who initiated ACE treatment were included in the study. Data were collected at baseline and during follow-up (FU) periods ranging from 6 weeks to 60 months. Gastrointestinal health-related quality of life (HRQoL) was assessed using the Pediatric Quality of Life Inventory Gastrointestinal Symptoms Module (PedsQL-GI), along with gastrointestinal symptoms, adverse events, and patient satisfaction reported by parents and patients.
A total of 38 children were included in the study, with 61% being male and a median age of 7.7 years (interquartile range 5.5–12.2). Among them, 58% were diagnosed with functional constipation (FC), 26% with an anorectal malformation, and 16% with Hirschsprung disease. About 22 children (58%) at 6 months, 16 (42%) at 12 months, 20 (53%) at 24 months, and 10 (26%) at 36 months completed the follow-up surveys. For children with FC, PedsQL-GI scores significantly increased at 12 and 24 months of follow-up. For children with organic causes, they significantly increased at 36 months of follow-up when reported by parents. Minor adverse events, such as granulation tissue, were reported in one-third of children, and 10% required a surgical revision of their ACE. Most parents and children reported that they would “probably” or “definitely” choose ACE treatment again.
ACE treatment had a positive perception among patients and parents and led to long-term improvement in gastrointestinal HRQoL in children with organic or functional defecation disorders.