When normal therapy fails, patients with functional constipation (FC) can participate in organized bowel management programs (BMPs) to control constipation or fecal incontinence. For a study, researchers sought to assess the effectiveness of BMPs for kids with FC who had neurodevelopmental problems or not.
They conducted a retrospective analysis of the kids with FC who participated in our BMP between 2014 and 2021. Stool/urinary continence, bowel habits, medical history, parent-reported outcomes measures (PROMs: Cleveland Constipation Score, Baylor Continence Scale, Vancouver Symptom Score for Dysfunctional Elimination), and Pediatric Quality of Life Inventory (PedsQL) were evaluated prior to and at least nine months after BMP.
The cohort had 156 individuals, with a follow-up of 627 days and a median age of 9 years (IQR: 389–808 days). Patients with FC alone (69%) and FC combined with a neurodevelopmental condition (31%), including attention-deficit/hyperactivity disorder (59%), autism spectrum disorder (33%), and obsessive-compulsive disorder (8%), were included in two sub-cohorts. Following the intervention, both groups substantially improved their follow-up bowel movement frequency and continence (39%-90% neurodevelopmental, 44%-82% FC solo, P<0.001) and urine continence (65%-90% neurodevelopmental, 69%-91% FC only, P<0.02). Most of the PROMs showed a substantial improvement at the follow-up. Overall PedsQL ratings in both groups improved clinically significant amounts (pre-and post-BMP difference >4.5).
Following a BMP, patients with FC, including those with and without a neurodevelopmental problem, saw a substantial improvement in bowel and urine continence. It will need further research to see whether this improvement in this difficult population will last for a longer length of time.