COLORECTAL DYSFUNCTION AND FECAL INCONTINENCE IN CHILDREN WITH SPINA-BIFIDA

Objectives To quantify colorectal neurogenic dysfunction in children w ith spina bifida and to evaluate the clinical efficacy of appropriate rehabilitation performed by the coloproctologist in the spina bifida t eam, Patients and methods The bowel function of 73 patients with conge nital (67) and acquired (six) spinal lesions (age 7-25 years) was eval uated by one physician, Evacuation habit was classified as full bowel control, mild and severe constipation or incontinence. Fifty-two child ren had mild or severe incontinence or constipation, 22 of whom were t reated by the coloproctologist using biofeedback or conventional thera py; 30 were not treated. The outcome was compared between the groups R esults Bowel constipation remained stable in 90% and was complicated i n 10% of the untreated patients, while it ameliorated in 59% of patien ts who received specialist treatment. Conclusion Neurogenic bowel dysf unction needs specialist management to achieve better results, using t he concept of controlled incontinence. There was no significant differ ence between conventional therapy and biofeedback methods.