Arneberg, Hilde

Mattsson, Gunilla Glad

Mattsson, Sven

Skevig, Mona

Sommer, Finn

Wide, Peter

English

PubMed

Peter Wide

Mona Skevig

Hilde Arneberg

Finn Sommer

Gunilla Mattsson

Sven Mattsson

Springer - Publisher Connector

BioMed CentralCerebrospinal Fluid Research
ssOpen AcceOral presentation
Effectiveness and independence - different treatments of 
neurogenic bowel dysfunction in children with myelomeningocele
Peter Wide*1, Mona Skevig2, Hilde Arneberg2, Finn Sommer2, 
Gunilla Glad Mattsson1 and Sven Mattsson1
Address: 1Department of IKE/Pediatrics, University of Linköping, SE 581 85 Linköping, Sweden and 2Department of Neuropediatrics, 
Rikshospitalet, Oslo, Norway
Email: Peter Wide* - peter.wide@lio.se
* Corresponding author    
Background
Constipation is a major problem in children with mye-
lomeningocele and may result in a range of problems
from impaired growth to faecal incontinence. Treatment
regimes differ between countries and comparisons
between the different methods are rare. Apart from effec-
tiveness aspects as time needed and factors related to pos-
sibilities of independence are also important. Dominating
treatment regimes are oral laxatives, transrectal irrigation
(TRI) and different kinds of irrigation via appendicos-
tomy.
Materials and methods
A questionnaire was sent to all children with myelom-
eningocele aged 7-16 years living in the south eastern
health region and the region of Skåne in Sweden (n = 96)
and in the south and east regions of Norway (n = 84). The
questionnaire covered several areas including, bowel and
bladder emptying, urinary infections and independence at
the toilet and had separate parts for the child and parents.
The quality of life instrument PedsQL© was also used. A
total of 180 questionnaires were sent out and 106 (59%)
answers were received. Distribution between genders was
equal. Analysis of drop-outs showed no significant differ-
ences according to age, gender and regime of bowel emp-
tying.
Results
Distribution according to regime of bowel emptying was:
spontaneous 18 (17%), TRI 52 (49%), appendicostomy
32 (30%) and other regimes 4 (4%). Of the 106 children
13 used some oral treatment to improve bowel function
in most cases combined with one of the regimes above.
Children using appendicostomy as well as their parents
reported higher satisfaction compared to children using
TRI. On the other hand parents to children using appen-
dicostomy reported longer time on toilet compared to
those of children using TRI. Faecal incontinence was less
frequent in the appendicostomy group but the need of
support to perform the procedure was the same. Children
using TRI did not report different quality of life according
to PedsQL© than those with appendicostomy. The chil-
dren with myelomeningocele reported lower quality of
life than the normal population.
Conclusion
Transrectal and appendicostomal irrigation are the domi-
nating methods of bowel treatment in children with mye-
lomeningocele in at least parts of Sweden and Norway.
Higher parent and child satisfaction was associated with
use of appendicostomy, compared to TRI, but there was
no significant difference in quality of life. Faecal inconti-
nence was significantly less frequent in the appendicos-
tomy group, but it takes longer time for this group to
empty the bowel. Furthermore, the parents reported no
from 53rd Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida
Belfast, UK. 24-27 June 2009
Published: 27 November 2009
Cerebrospinal Fluid Research 2009, 6(Suppl 2):S31 doi:10.1186/1743-8454-6-S2-S31
<supplement> <title> <p>53rd Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida</p> </title> <note>Meeting abstracts - A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1743-8454-6-S2-full.pdf">here</a>.</note> </supplement>
This abstract is available from: http://www.cerebrospinalfluidresearch.com/content/6/S2/S31
© 2009 Wide et al; licensee BioMed Central Ltd. Page 1 of 2
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difference in the need of support between the two meth-
ods of bowel emptying. Families should be included in
choice of bowel regime.Page 2 of 2
(page number not for citation purposes)


Effectiveness and independence - different treatments of neurogenic bowel dysfunction in children with myelomeningocele

Wide Peter

Skevig Mona

Arneberg Hilde

Sommer Finn

Mattsson Gunilla

Mattsson Sven

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Effectiveness and independence - different treatments of neurogenic bowel dysfunction in children with myelomeningocele

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