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Medline ® Abstract for Reference 125

of 'Chronic functional constipation and fecal incontinence in infants and children: Treatment'

Treatment of severe childhood constipation with restorative proctocolectomy.
Asipu D, Jaffray B
Arch Dis Child. 2010;95(11):867.
OBJECTIVE: To describe the clinical features of children with severe constipation and their outcome after restorative proctocolectomy.
DESIGN: Observational study and health status questionnaire using gastrointestinal quality of life score (GIQL).
SETTING: English regional paediatric surgery service.
PATIENTS: Five children were identified, with severe constipation, whose symptoms had not improved with either prolonged medical therapy or colonic lavage using an antegrade colonic enema procedure. All had required a stoma to resolve their constipation. Intervention All underwent restorative proctocolectomy.
RESULTS: All children are stooling through their anus. The mean stool frequency is 6/day. None have daytime incontinence, and none require any further therapy for constipation. Complication rates have been low with no permanent morbidity. The mean GIQL 3 years following restorative proctocolectomy was 89 (SD 29).
CONCLUSIONS: In highly selected cases, restorative proctocolectomy may allow resolution of the symptoms of severe constipation and avoid leaving a child with a permanent stoma.
Department of Paediatric Surgery, The Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK.