Efficacy of bowel management program for improving quality of life in children with postoperative fecal incontinence

Open Access

Abstract

Background: Fecal incontinence is still a severe consequence of surgical repair of anorectal abnormalities and Hirschsprung disease in young patients, significantly reducing quality of life. The purpose of this study was to assess the efficacy of a systematic bowel management program in enhancing the quality of life for children with postoperative fecal incontinence. Methods & Material: This quasi-experimental study was carried out at Mymensingh Medical College Hospital in Bangladesh from July 2023 to December 2024. A purposive sample was used to enroll 50 children aged 3 to 12 years old who had postoperative fecal incontinence after surgical repair of anorectal deformity or Hirschsprung disease. A seven-day bowel control treatment involving saline enemas with or without glycerin was implemented. At baseline and 12-week follow-up, quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL 4.0), which included domains such as physical, emotional, social, and school functioning. Data were entered and analyzed using SPSS version 26. Results: The bowel management treatment resulted in considerable improvements in all quality-of-life dimensions. Physical function ratings improved from 72.0±24.2 to 96.8±3.1 (p<0.001), emotional function from 68.2±28.2 to 88.3±9.7 (p<0.001), social function from 74.2±25.0 to 98.2±6.1 (p<0.001), and school function from 76.0±12.5 to 92.1±7.5 (p<0.001). 96% of patients had their stool consistency restored. Compliance was acceptable for 88% of individuals. Age and educational level were found to have a strong link with enema requirements. Conclusion: Structured bowel management programs increase quality of life in children with postoperative fecal incontinence by providing a non-invasive therapeutic strategy with high compliance and considerable functional improvements.