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Title
Treatment Outcome in Patients with Pediatric Encopresis
Author
Jeong Eun Kim, Soon Sup Chung, Ung Chae Park
Place of duty
Publicationinfo
Journal of Korean Soc Coloproctol 2002 | Vol.18 No.5 | 294 ~ 299, 6 pages
Keyword
À¯ºÐÁõ; Ä¡·á; Encopresis; Treatment;
Abstract
Purpose:
The causes of encopresis are complex and multifactorial. Through application of new sophisticated techniques and armamentarium, it has been possible to find more specific aspects of the anorectal function in pediatric patients
with
refractory defecation disorders. However, quality research of which therapeutic option could be suitable, is still lacking. The current study was designed to assess outcome of treatment according to the treatment algorithm based on the clinical
and
physiologic findings.
Methods:
22 patients (15 boys, 7 girls) with encopresis were analyzed, retrospectively. For exclusion of the organic cause, barium contrast study and anoscopy were carried out in all cases. Patients were categorized and made treatment
algorithm
by using leading symptoms and findings of anorectal physiologic tests. Treatment outcomes were analysed in the basis of respective therapeutic options.
Results:
Patients were categorized as constipation dominant group (n=15) and incontinence dominant group (n=7). Suggested etipathogeneses were as follows; fecal impaction and/or motility disorder (n=7), overflow incontinence (n=6), sensory
defect
of the rectum (n=4), puborectalis incoordination (n=3), anal hypertonia (n=2). Treatment options were as follows; conventional therapy (CT) only (n=7), CT plus biofeedback (n=9), CT plus balloon sensory retraining (n=4), and CT plus internal
sphincterotomy or Nitroglycerine application (n=2). All patients were undertaken a toilet training and psychologic consultation. Regarding to the therapeutic outcome, 19 (86 percent) of overall 22 patients were improved in the mean period of 2.5
(range,
0.1¡7) years follow-up.
Conclusions:
If therapy could be undertaken according to the optional algorithm based on the clinical and physiologic findings, it could be useful guide for clinical decision making to help the therapy. Moreover, through the combination
therapy
including medication, psychological consultation, and biofeedback treatment, encopretic children achieve acceptable outcome with a long-term compliance.
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À¯ºÐÁõ; Ä¡·á; Encopresis; Treatment;