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J Pediatr 2021 May 12. Epub 2021 May 12.

Department of Pediatrics. Uniformed Services University of the Health Sciences. Bethesda, MD.

Objective: To evaluate the relationship between parental injury and illness and disorders of gut brain interaction (DGBI) in children.

Study Design: A self-controlled case series using data from the Military Health System Data Repository compared ICD-9 identified DGBI related outpatient visits and prescriptions in 442,651 children ages 3-16 years in the two-years before and the two-years after the injury and/or illness of their military parent. Negative binomial regression was used to compare visit rates for constipation, fecal incontinence, abdominal pain, irritable bowel syndrome, and a composite of these before and after parental injury and/or illness. Read More

J Pediatr (Rio J) 2021 May 12. Epub 2021 May 12.

Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Departamento de Pediatria, Divisão de Gastroenterologia, Hepatlogia e Nutrição Pediátrica, Botucatu, SP, Brazil. Electronic address:

Objective: Developing and validating a disease-specific instrument in the Brazilian Portuguese language to assess the Health-Related Quality of Life of children with functional constipation, applied to parents/caregivers.

Methods: The process of developing the questionnaire was carried out in the following steps: items generation concerning functional constipation; elaboration of the preliminary questionnaire; assessment by health professionals; identifying problems or inconsistencies by the researchers; improvement of the questions; obtaining a final questionnaire named Pediatric Functional Constipation Questionnaire-Parent Form (PedFCQuest-PR) with 26 questions divided into four domains. Responses options use a Likert scale based on the events of the last four weeks. Read More

Front Pediatr 2021 27;9:600316. Epub 2021 Apr 27.

Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

The aim of this study was to describe the details of laparoscopic-assisted reoperative surgery for Hirschsprung's disease (HSCR) with overflow fecal incontinence, and to retrospectively compare laparoscopic-assisted surgery with transabdominal pull-through surgery. We retrospectively analyzed patients with HSCR with overflow fecal incontinence after the initial surgery in our center between January 2002 and December 2018. Pre-operative, peri-operative, and post-operative data were recorded for statistical analysis. Read More

Dig Dis Sci 2021 May 12. Epub 2021 May 12.

Pediatric Gastroenterology and Hepatology Research Center, Pediatric Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Qarib St, Keshavarz Blvd, 14194 33151, Tehran, Iran.

Background: We compared the effects of transcutaneous functional electrical stimulation (TFES) and biofeedback therapy with TFES alone in a cohort of children with functional non-retentive fecal incontinence (FNRFI).

Methods: This prospective, single-center randomized clinical trial was performed on 40 children with FNRFI. Patients were randomly allocated into two equal treatment groups. Read More

Tech Coloproctol 2021 May 12. Epub 2021 May 12.

Department of Surgery, Groene Hart Ziekenhuis, Bleulandweg 10, 2803 HH, Gouda, The Netherlands.

Background: Fecal incontinence is a multifactorial problem and its etiology is complex. Various therapies are available and different success rates have been described. The aim of this study was to assess the effectiveness and safety of non-dynamic graciloplasty in patients with passive fecal incontinence. Read More

Asian J Surg 2021 May 5. Epub 2021 May 5.

Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; The University of Sydney, Discipline of Surgery, Sydney, New South Wales, Australia.

Background: Lateral internal sphincterotomy (LIS) remains the gold standard surgical approach for the management of chronic anal fissures (CAF). The procedure however, is complicated by the risk of postoperative incontinence. Intrasphincteric Botulinum Toxin (BT) has gained popularity as an alternative approach, despite being inferior to LIS with regards to cure rates. Read More

J Pediatr Surg 2021 Apr 5. Epub 2021 Apr 5.

Division of Pediatric Surgery, Department of Surgery, University of Utah School of Medicine, 100 N. Mario Ceppechi Drive, Suite 3800, Salt Lake City, UT 84113, United States.

Background: An appendicostomy (ACE) is a surgical option for antegrade enemas in children with severe constipation and/or fecal incontinence who have failed medical management.  In 2019, we initiated an expedited post-operative protocol and sought to examine our short-term outcomes compared with our historical cohort.

Methods: A retrospective review was performed of all children undergoing ACE between 2017 and 2020. Read More

Pediatr Med Chir 2021 May 7;43(1). Epub 2021 May 7.

Pediatric Surgery, Ca' Foncello Hospital, Treviso.

Constipation and fecal incontinence in pediatric patients are conditions due to either functional or organic bowel dysfunction and may represent a challenging situation both for parents, pediatricians, and pediatric surgeons. Different treatments have been proposed throughout the past decades with partial and alternant results and, among all proposed techniques, in the adult population the Transanal Irrigation (TAI) has become popular. However, little is known about its efficacy in children. Read More

World J Gastroenterol 2021 Apr;27(15):1553-1562

Gastroenterology and Endoscopy Unit, The Nazareth Hospital, EMMS, Nazareth 464000, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.

Faecal incontinence (FI) is a debilitating common end result of several diseases affecting the quality of life and leading to patient disability, morbidity, and increased societal burden. Given the various causes of FI, it is important to assess and identify the underlying pathomechanisms. Several investigatory tools are available including high-resolution anorectal manometry, transrectal ultrasound, magnetic resonance imaging, and electromyography. Read More

Z Kinder Jugendpsychiatr Psychother 2021 May 7:1-10. Epub 2021 May 7.

Governor Kremers Centre, Department of Urology, Maastricht University Medical Centre, The Netherlands.

Incontinence and functional gastrointestinal disorders are common in young children and are associated with higher rates of psychological symptoms and mental disorders. This article focuses on the mutual association between incontinence and related toilet refusal syndrome, parental stress, and children's psychopathology especially in young children. Children's psychological symptoms, mental disorders, and parental stress levels were assessed in 38 parent-child dyads involving children with incontinence and 42 dyads of typically developing (TD) children. Read More

J Wound Ostomy Continence Nurs 2021 May-Jun 01;48(3):239-250

Manuel Rodríguez-Palma, PhD, MSN, RN, Nursing Home "José Matía Calvo," Cádiz, Spain; and Executive Member of Spanish Pressure Ulcer Advisory Panel.

Incontinence-associated dermatitis (IAD) has been studied over the last decades, but gaps in the knowledge related to its identification, etiological agents, and risk factors remain. We carried out a scoping review about IAD that included systematic reviews, experimental, and observational studies about IAD and its potential risk factors. We retrieved 24 articles that described 100 potential risk factors and which were synthesized by the authors and proposed to a panel of experts. Read More

Dis Colon Rectum 2021 Apr 26. Epub 2021 Apr 26.

Pelvic Floor Disorders Center, Section of Colon and Rectal Surgery, Massachusetts General Hospital, Boston, MA Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH Department of Surgery, The University of Chicago Medicine, Chicago, IL Department of Surgery, Mount Sinai School of Medicine, New York, NY Pelvic Floor Disorders Center, Section of Colon and Rectal Surgery, Massachusetts General Hospital, Boston, MA Division of Colorectal Surgery, University of Massachusetts-Baystate, Springfield, MA Department of General Surgery, Division of Colorectal Surgery, Stanford University Medical Center, Stanford, CA Pelvic Floor Disorders Center, Section of Colon and Rectal Surgery, Massachusetts General Hospital, Boston, MA.

Background: The surgical management of rectal prolapse is constantly evolving, yet numerous clinical trials and meta-analyses studying operative approaches have failed to make meaningful conclusions.

Objective: To report on preliminary data captured during a large-scale quality improvement initiative to measure and improve function in patients undergoing rectal prolapse repair.

Design: Retrospective analysis of prospectively collected surgical quality improvement data. Read More

Female Pelvic Med Reconstr Surg 2021 May 4. Epub 2021 May 4.

From the Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh/Magee-Womens Research Institute, Pittsburgh Department of Obstetrics and Gynecology, Hospital of University of Pennsylvania, Philadelphia, PA Department of Obstetrics, Gynecology & Reproductive Sciences, UC San Diego Health, San Diego, CA Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women's & Infants Hospital, Providence, RI Department of Obstetrics and Gynecology, Duke University Medical Center, Durham Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, NC Albany Medical College, Albany, NY University of New Mexico, Albuquerque, NM Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.

Objectives: High-level evidence for second-line noninvasive treatments for fecal incontinence in women is limited. We present the rationale for and design of the NeuromOdulaTion for Accidental Bowel Leakage trial, a randomized controlled trial of percutaneous tibial nerve stimulation (PTNS) and validated sham stimulation in women with refractory accidental bowel leakage.

Methods: The rationale and goals for a 2-part study with a run-in phase, use of a generic pulse generator for PTNS and sham stimulation, masking, participant inclusion, primary and secondary outcome measures, and adverse event collection are described. Read More

Colorectal Dis 2021 May 4. Epub 2021 May 4.

Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston.

Introduction: Faecal incontinence (FI) is estimated to affect 8.9% of women in the US, with a significant impact on quality of life. Our aim was to compare urinary symptoms in patients with and without FI with different degrees of severity. Read More

Colorectal Dis 2021 May 3. Epub 2021 May 3.

Hospital Universitario Virgen del Rocio, Department of Surgery, Sevilla, Spain.

FaecaI Incontinence (FI) affects over 5% of women worldwide (1) with obstetrical injury being one of the most important causes (2). Sphincteroplasty (SP) is one of the surgical techniques described to repair this injury. This specific procedure has been associated with good short-term outcomes, although the association with other treatments, such as sacral neurostimulation, may be needed (3). Read More

Dig Dis Sci 2021 May 3. Epub 2021 May 3.

The Wingate Institute of Neurogastroenterology, Queen Mary University of London, 26 Ashfield Street, London, E1 2AJ, UK.

Background: Anorectal manometry (ARM) is essential for identifying sphincteric dysfunction. The International Anorectal Physiology Working Group (IAPWG) protocol and London Classification provide a standardized format for performing and interpreting ARM. However, there is scant evidence to support timing and number of constituent maneuvers. Read More

J Anus Rectum Colon 2021 28;5(2):137-143. Epub 2021 Apr 28.

Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan.

Objectives: To clarify the long-term outcomes of transvaginal anterior levatorplasty with posterior colporrhaphy for symptomatic rectocele with defecographic changes.

Methods: Consecutive patients undergoing transvaginal anterior levatorplasty with posterior colporrhaphy for symptomatic rectocele were prospectively registered and retrospectively reviewed using medical records. Symptoms, fecal incontinence, and defecographic findings were evaluated before and after surgery. Read More

Cureus 2021 Mar 29;13(3):e14175. Epub 2021 Mar 29.

Surgery, S.C.B. Medical College and Hospital, Cuttack, IND.

Introduction Most of the patients with rectal prolapse complain of fecal incontinence followed by constipation. Surgery is the only definitive treatment option for rectal prolapse. There are two approaches: either transanal/perineal or transabdominal. Read More

J Visc Surg 2021 Apr 27. Epub 2021 Apr 27.

Colorectal surgery unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura city, Egypt.

Background: The management of recurrent anal fistulas after previous surgery is usually challenging. The present study aimed to review the characteristics and treatment outcomes of recurrent anal fistulas as compared to primary anal fistulas.

Methods: The records of patients with anal fistula who underwent surgery were reviewed. Read More

J Clin Med 2021 Apr 13;10(8). Epub 2021 Apr 13.

Department of Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.

Neurogenic/neuropathic bowel dysfunction (NBD) is common in children who are affected by congenital and acquired neurological disease, and negatively impacts quality of life. In the past, NBD received less attention than neurogenic bladder, generally being considered only in spina bifida (the most common cause of pediatric NBD). Many methods of conservative and medical management of NBD are reported, including relatively recently Transanal Irrigation (TAI). Read More

J Clin Med 2021 Apr 14;10(8). Epub 2021 Apr 14.

International Collaboration on Repair Discoveries (ICORD), Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.

Objective: To explore the association between bowel dysfunction and use of laxatives and opioids in an acute rehabilitation setting following spinal cord injury (SCI).

Methods: Data was collected regarding individuals with acute traumatic/non-traumatic SCI over a two-year period (2012-2013) during both the week of admission and discharge of their inpatient stay.

Results: An increase in frequency of bowel movement (BM) ( = 0. Read More

Wounds 2021 Apr;33(4):E31-E33

Arizona Burn Center, Phoenix, Arizona.

Incontinence-associated dermatitis (IAD) is considered a cause of moisture-associated skin damage after prolonged exposure to urinary and fecal incontinence. While partial-thickness burns are often managed with topical therapies, daily dressing changes, patient positioning, hydration, nutrition, and pain management, deep partial-thickness and full-thickness burn injuries require surgical excision and, ultimately, skin grafting. The elderly and very young as well as those with medical comorbidities can develop urinary and fecal incontinence. Read More

World J Gastroenterol 2021 Apr;27(14):1451-1464

Department of Coloproctology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China.

Background: Currently, rectovaginal fistula (RVF) continues to be a surgical challenge worldwide, with a relatively low healing rate. Unclosed intermittent suture and poor suture materials may be the main reasons for this.

Aim: To evaluate the efficacy and safety of stapled transperineal repair in treating RVF. Read More

Dis Colon Rectum 2021 Apr 19. Epub 2021 Apr 19.

Department of Surgery, Amsterdam UMC, University of Amsterdam, G4, Post box 22660, 1100 DD Amsterdam, the Netherlands Department of Abdominal Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France Department of surgery, Tergooi Hospital, The Netherlands, Post box 10016, 1201 DA Hilversum, the Netherlands Department of surgery, Mansoura University Hospital, Gomhouria street 60, 35516, Mansoura, Egypt.

Background: Redo anastomosis can be considered in selected patients with persistent leakage, stenosis, or local recurrence. This is technically challenging and little is known about the functional outcomes after this seldomly performed type of surgery.

Objective: The aim of this study was to compare functional outcomes and quality of life between redo anastomosis and primary successful anastomosis following total mesorectal excision (TME) for rectal cancer. Read More

Colorectal Dis 2021 Apr 26. Epub 2021 Apr 26.

Neurogastroenterology Unit, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark.

Aim: To study anorectal function in long-term survivors after combined, curatively intended, chemoradiotherapy and endorectal brachytherapy for low rectal cancer.

Methods: case-control design. We compared anorectal function by anal manometry, anal EndoFLIP and rectal bag distension in rectal cancer patients (RCP) and healthy, normal subjects (NS). Read More

Best Pract Res Clin Rheumatol 2021 Apr 21:101686. Epub 2021 Apr 21.

Raynaud's and Scleroderma Programme, NIHR Biomedical Research Centre, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. Electronic address:

Scleroderma is a chronic autoimmune disorder involving multiple organs and very commonly the gastrointestinal (GI) system; nevertheless, data on the involvement of the anal sphincter and consequent faecal incontinence (FI) are inadequate. FI in scleroderma was first reported in 1994 by Engel and colleagues, but its impact of added health care costs and declining quality of life (QoL) is poorly determined. Up to 40% of patients with GI involvement complain of FI, however, the quality of data available is poor owing to majority of the studies being retrospective and case reports or series of small study size. Read More

Spinal Cord Ser Cases 2021 Apr 23;7(1):34. Epub 2021 Apr 23.

General Surgery and Trauma Team, ASST Grande Ospedale Metropolitano Niguarda, Università degli Studi di Milano, Milano, Italy.

Introduction: Patients with severe neurogenic bowel dysfunction (NBD) may undergo the Malone antegrade continence enema (MACE) surgery to perform antegrade bowel irrigation (ABI). The standard approach may be prevented by a previous appendectomy or complicated by appendicular stenoses and/or stomal leakages. We present the experience by our tertiary referral center for NBD, adopting a modified surgical technique, based on a neoappendix with the terminal ileum to preserve the natural anti-reflux mechanism of the ileocecal valve and avoid stool leakage, and a largely available transanal irrigation (TAI) system to catheterize the neoappendix and perform ABI. Read More

Pan Afr Med J 2021 20;38:64. Epub 2021 Jan 20.

Département de Chirurgie, Faculté de Médecine, Cliniques Universitaires de Lubumbashi, Université de Lubumbashi, Lubumbashi, République Démocratique du Congo.

Anorectal malformations (ARM) are developmental anomalies of the genitor anal elements, they represent a wide range of anomalies. An early diagnosis allows a better management as it reduces mortality associated with ARM, especially in developing countries. A prospective cross-sectional study has been carried, including patients from 0 to one year, admitted in our service for ARM. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2021 Apr;24(4):335-343

Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China.

To compare the effects of 3 treatment strategies (emergent surgery, self-expanding metallic stents, self-expanding metallic stents plus neoadjuvant chemotherapy) on postoperative anal function and quality of life in patients with complete obstructive left hemicolon cancer. A retrospective cohort study was conducted. Clinical data of patients with complete obstructive left hemicolon cancer admitted to General Surgery Department of Beijing Chaoyang Hospital between January 2017 and October 2019 were retrospectively collected. Read More