Summary
Introduction
The International Children's Continence Society (ICCS) aims to improve the quality
of life in children with lower urinary tract dysfunction. A substantial portion of
children also have problems with bowel dysfunction. There is a lack of evidence-based
information on managing neurogenic bowel dysfunction (NBD) in children.
Objective/methods
The ICCS aimed to provide an up-to-date, selective, non-systematic review of NBD's
definitions, assessment, and treatment.
Results
Specific definitions and terminology are defined within the document. Recommendations
and considerations for physical assessment, history taking, and diagnostic studies
are made. Management updates, both surgical and non-surgical, are provided as well
as recommendations for follow-up and monitoring of individuals with NBD.
Conclusion
This review of the current literature will help guide NBD management and research
to improve NBD care.
Keywords
Abbreviations:
NBD (Neurogenic bowel dysfunction), SB (Spina bifida), ICCS (International Children's Continence Society), AXR (Abdominal radiographs), PEG (Polyethylene glycol), ACE (Antegrade colonic/continence enema), MACE (Malone antegrade continence enema)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Neurogenic bowel dysfunction in children and adolescents.J Clin Med. 2021 Apr 13; 10: 1669
- Transition to adult care for patients with spina bifida.Phys Med Rehabil Clin. 2015 Feb; 26: 29-38
- Neurogenic bowel dysfunction: the impact of the central nervous system in constipation and fecal incontinence.Gastroenterol Clin N Am. 2022 Mar; 51: 93-105
- Bowel management and quality of life in children with spina bifida in South Korea.Gastroenterol Nurs. 2017 Jun; 40: 208-215
- Problematic aspects of faecal incontinence according to the experience of adults with spina bifida.J Rehabil Med. 2009 Jun; 41: 506-511
- Reversible ventriculoperitoneal shunt dysfunction and chronic constipation: case report.J Neurosurg Pediatr. 2018 Aug; 22: 147-150
- All incontinence is not created equal: impact of urinary and fecal incontinence on quality of life in adults with spina bifida.J Urol. 2017 Mar; 197: 885-891
- Bowel management and continence in adults with spina bifida: results from the national spina bifida patient Registry 2009-15.J Pediatr Rehabil Med. 2017 Dec 11; 10: 335-343
- Spina bifida research gaps explored - a qualitative survey among adults with spina bifida and parents of children with spina bifida in.2019
- Who is managing the bowels? A survey of clinical practice patterns in spina bifida clinics.J Pediatr Rehabil Med. 2021; 14: 675-679
- First translational consensus on terminology and definitions of colonic motility in animals and humans studied by manometric and other techniques.Nat Rev Gastroenterol Hepatol. 2019 Sep; 16: 559-579
- Neurogenic bowel treatments and continence outcomes in children and adults with myelomeningocele.J Pediatr Rehabil Med. 2020; 13: 685-693
- The new Rome IV criteria for functional gastrointestinal disorders in infants and toddlers.Pediatr Gastroenterol Hepatol Nutr. 2017 Mar; 20: 1-13
- Lifespan bowel management protocol [Internet].2022 (Available from:)
- International Children's Continence Society's recommendations for therapeutic intervention in congenital neuropathic bladder and bowel dysfunction in children.Neurourol Urodyn. 2012 Jun; 31: 615-620
- Using a decision tree to guide bowel management in spina bifida.J Pediatr Nurs. 2019 Apr 29; 47: 68-72
- Maltreatment of children under age 2 with specific birth defects: a population-based study.Pediatrics. 2015 Dec; 136: e1504-e1512
- Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN.J Pediatr Gastroenterol Nutr. 2014 Feb; 58: 258-274
- Management of neurogenic bowel dysfunction in adults after spinal cord injury: clinical practice guideline for health care providers.Top Spinal Cord Inj Rehabil. 2021 Spring; 27: 75-151
- Use of pelvic ultrasound in the diagnosis of megarectum in children with constipation.J Pediatr Surg. 2005 Dec; 40: 1941-1944
- Transabdominal ultrasound of rectum as a diagnostic tool in childhood constipation.J Urol. 2008 May; 179: 1997-2002
- A summary of conference recommendations on dietary fiber in childhood. Conference on Dietary Fiber in Childhood, New York, May 24, 1994. American Academy of Pediatrics.Pediatrics. 1995 Nov; 96: 1023-1028
- Treatment of fecal incontinence with a comprehensive bowel management program.J Pediatr Surg. 2009 Jun; 44 (; discussion 1283-1284): 1278-1283
- Transanal irrigation for people with neurogenic bowel dysfunction: an integrative literature review.Gastroenterol Nurs Off J Soc Gastroenterol Nurses Assoc. 2022 Aug 1; 45: 211-230
- Consensus review of best practice of transanal irrigation in children.J Pediatr Gastroenterol Nutr. 2017 Mar; 64: 343-352
- Impact of transanal irrigation device in the management of children with fecal incontinence and constipation.J Pediatr Gastroenterol Nutr. 2020 Sep; 71: 292-297
- Global audit on bowel perforations related to transanal irrigation.Tech Coloproctol. 2016 Feb; 20: 109-115
- Transanal irrigation for neurogenic bowel disease, low anterior resection syndrome, faecal incontinence and chronic constipation: a systematic review.J Clin Med. 2021 Feb 13; 10: 753
- Anal plugs for the management of fecal incontinence in children and adults: a randomized control trial.J Clin Gastroenterol. 2007 Jan; 41: 45-53
- Tube cecostomy versus appendicostomy for antegrade enemas in the management of fecal incontinence in children: a systematic review.J Pediatr Surg. 2020 Jul; 55: 1196-1200
- No appendix is too short-simultaneous Mitrofanoff catheterizable vesicostomy and Malone antegrade continence enema (MACE) for children with spina bifida.Urology. 2018 Jun; 116: 205-207
- Sacral nerve stimulation: a promising therapy for fecal and urinary incontinence and constipation in children.J Pediatr Surg. 2015 Oct; 50: 1644-1647
- European Hernia Society guidelines on prevention and treatment of parastomal hernias.Hernia J Hernias Abdom Wall Surg. 2018 Feb; 22: 183-198
- Development, reliability and validation of a neurogenic bowel dysfunction score in pediatric patients with spina bifida.Neurourol Urodyn. 2016 Feb; 35: 212-217
- Neurogenic bowel dysfunction score.Spinal Cord. 2006 Oct; 44: 625-631
- Sexuality of female spina bifida patients: predictors of a satisfactory sexual function.Rev Bras Ginecol E Obstet Rev Fed Bras Soc Ginecol E Obstet. 2021 Jun; 43: 467-473
- Bowel function and care: guidelines for the care of people with spina bifida.J Pediatr Rehabil Med. 2020 Dec 22; 13: 491-498
- Ambulatory patients with spina bifida are 50% more likely to be fecally continent than non-ambulatory patients, particularly after a MACE procedure.J Pediatr Urol. 2017 Feb; 13: 60.e1-60.e6
- Assessment of neurogenic bowel symptoms with the bowel dysfunction score in children with spina bifida: a prospective case-control study.Pediatr Surg Int. 2020 Jul; 36: 773-777
- Independence does not come with the method--treatment of neurogenic bowel dysfunction in children with myelomeningocele.Acta Paediatr. 2014 Nov; 103: 1159-1164
- The severity of bowel dysfunction in patients with neurogenic bladder.J Urol. 2015 Nov; 194: 1336-1341
- The prevalence of small intestinal bacterial overgrowth and methane production in patients with myelomeningocele and constipation.Spinal Cord. 2014 Jan; 52: 61-64
- Prospective evaluation of the management of bowel dysfunction in children with neuropathic lower urinary tract dysfunction and its effect on bladder dynamics.J Pediatr Surg. 2019 Apr; 54: 805-808
- Family satisfaction, pain, and quality-of-life in emerging adults with spina bifida: a longitudinal analysis.Am J Phys Med Rehabil. 2013 Aug; 92: 641-655
- Depressive symptoms in adults with spina bifida.Rehabil Psychol. 2015 Aug; 60: 246-253
- A review of the social, psychological, and economic burdens experienced by people with spina bifida and their caregivers.Neurol Ther. 2013 Dec; 2: 1-12
- A qualitative exploration of the experiences of children with spina bifida and their parents around incontinence and social participation.Child Care Health Dev. 2015 Nov; 41: 954-962
Article info
Publication history
Published online: January 30, 2023
Accepted:
January 25,
2023
Received in revised form:
January 23,
2023
Received:
September 20,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
