Quality of life for children with fecal incontinence after surgically corrected anorectal malformation

Purpose: The aim of this study was to investigate influences of fecal incon tinence on children's quality of life after surgically corrected anorectal malformation. Methods: Seventy-one children with anorectal malformation underwent follow- up for 8 to 16 years postoperatively. They were divided into good, fair, an d poor groups by assessment of anal function. The quality of life was inves tigated by self-structured disease impact questionnaires and Achenbach's Ch ild Behavior Check List (CBCL). A quality-of-life scoring criteria was esta blished to assess quality of life of the 71 children with operated anorecta l malformation and controls. Results: Owing to fecal incontinence, 12 (16.9%) children reported that the re were problems in peer relationships; school absences happened in 13(18.3 %) children; 17(23.9%) children had to restrict themselves to certain food. Based on CBCL, 13 (18.3%) children had behavior problems. The behavior pro blems in children with poor fecal continence (66.7%) were significantly hig her than those of children with good fecal continence (8.6%). According to the quality-of-life scoring criteria, the scores of children with operated anorectal malformation (9.4 +/- 3.7) were significantly lower than those of the controls (11.2 +/- 0.9), The scores of children with poor fecal contin ence (4.8 +/- 1.4) were significantly lower than those of children with goo d fecal continence (10.9 +/- 1.2). Conclusions: The children with poor fecal continence have poor quality of l ife caused by fecal dysfunction. Attention should be paid to the rehabilita tion of fecal continence after surgery, such as bower training and biofeedb ack therapy. The somatic and psychological care and long-term follow-up are necessary to improve the quality of life. Copyright (C) 2000 by W.B. Saund ers Company.