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

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...

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Published in:	Journal of pediatric surgery Vol. 36; no. 9; pp. 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:	Journal Article Conference Proceeding
Language:	English
Published:	Philadelphia, PA Elsevier Inc 01-09-2001 Elsevier
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 Anorectal malformations behavioral treatment incontinence multidisciplinary treatment chronic constipation biopsychosocial approach Human Anorectal Congenital disease Statistical study Chemotherapy Treatment Malformation Digestive diseases Intestinal disease Complication Anal incontinence Behavior therapy Constipation Child Anorectal disease Multidisciplinary
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Summary:	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.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0022-3468 1531-5037
DOI:	10.1053/jpsu.2001.26368