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Group Treatment of Fecal Incontinence: A Description of an Interdisciplinary Intervention. J Pediatr Gastroenterol Nutr 2019 09;69(3):e70-e74

Date

05/07/2019

Pubmed ID

31058779

DOI

10.1097/MPG.0000000000002372

Scopus ID

2-s2.0-85070820143

Abstract

INTRODUCTION: Approximately 5% of children in the United States have chronic fecal incontinence. Unfortunately, standard medical management of fecal incontinence fails in 20% to 60% of cases. A combined medical-behavioral model is often recommended in these cases. The purpose of this pilot study was to describe an interdisciplinary group-based treatment for fecal incontinence in school-aged children, and to present a description of changes in treatment adherence rates that affect clinical effectiveness.

METHOD: Poop group employed a developmentally appropriate model of care in which caregivers and children participated in separate but simultaneously held therapy groups. This interdisciplinary 6-week protocol is designed to increase appropriate stooling, decrease soiling events, and increase medication adherence pre- to post-treatment. Group sessions focus on the GI system, medication, toilet sitting posture, hydration, fiber, and behavior contracts. In addition, participant families consult with an Advanced Nurse Practitioner privately at each session discussing symptoms and making medication modifications as needed.

RESULTS: Nineteen families completed the 6-week protocol. Appropriate stool frequency was improved (P ≤ 0.01), and soiling was reduced (P ≤ 0.00). Medication adherence was also improved (P ≤ 0.04). Treatment results were maintained at 1-month follow-up.

DISCUSSION: A developmentally targeted intervention and interdisciplinary focus of treatment likely account for treatment successes.

CONCLUSION: Poop group may be an effective interdisciplinary treatment option for families of children who fail traditional outpatient treatment.

Author List

Gonring K, Dolan B, Kapke TL, Begotka A, Sood M, Silverman AH

Authors

Andrea M. Begotka PhD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Theresa L. Kapke MD Assistant Professor in the Anesthesiology department at Medical College of Wisconsin
Alan Silverman PhD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Behavior Therapy
Child
Child, Preschool
Family
Fecal Incontinence
Female
Humans
Laxatives
Male
Medical Records
Patient Care Team
Patient Compliance
Retrospective Studies