Multidisciplinary behavioral treatment of defecation problems: A controlled study in children with anorectal malformations

• Published in: Journal of pediatric surgery 2001-09, Vol.36 (9), p.1350-1356
• Main Authors: van Kuyk, E.M., Wissink-Essink, M., Brugman-Boezeman, A.T.M., Oerlemans, H.M., Nijhuis-van der Sanden, M.W.G., Severijnen, R.S.V.M., Festen, C., Bleijenberg, G.
• Format: Article
• Language: English
• Subjects: Anal Canal - abnormalities; Analysis of Variance; Anorectal malformations; Behavior Therapy - methods; behavioral treatment; Biological and medical sciences; biopsychosocial approach; Child; Child, Preschool; chronic constipation; Congenital Abnormalities - diagnosis; Constipation - diagnosis; Constipation - therapy; Defecation; Fecal Incontinence - diagnosis; Fecal Incontinence - therapy; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Humans; incontinence; Male; Malformations; Medical sciences; multidisciplinary treatment; Prospective Studies; Reference Values; Severity of Illness Index; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Treatment Outcome
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1053/jpsu.2001.26368

Background/Purpose: The most frequent consequences of being born with an anorectal malformation (ARM) are problems with fecal continence and constipation, which can have various negative implications. In this prospective, controlled study the effect of multidisciplinary behavioral treatment dealing with these problems is evaluated. Methods: The effect of multidisciplinary behavioral treatment was studied in 24 children (15 boys, 9 girls; mean age 5.8 years). Thirteen children were allocated to the treatment condition. The 11 children allocated to the waiting list control group also were treated after a waiting period of 6 months. Children underwent follow-up after treatment. Results: Compared with a waiting list control group, the experimental treatment group scores significantly better on 2 important measures (“Templeton,” “Percentage of feces in toilet”). Although young children had poorer scores than older children before treatment, no significant differences in the favorable outcome of treatment were found between both groups after treatment. No effect of type of ARM on treatment was found either. The results of multidisciplinary behavioral treatment remain stable over a mean follow-up period of 7 months. Conclusion: Multidisciplinary behavioral treatment is an important and valuable supplement to the standard medical treatment of children born with ARM suffering from chronic defecation problems. J Pediatr Surg 36:1350-1356. Copyright © 2001 by W.B. Saunders Company.