Document Detail


Behavioural and cognitive interventions with or without other treatments for the management of faecal incontinence in children.
MedLine Citation:
PMID:  16625557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Faecal incontinence is a common and potentially distressing disorder of childhood.
OBJECTIVES: To assess the effects of behavioural and/or cognitive interventions for the management of faecal incontinence in children.
SEARCH STRATEGY: We searched the Cochrane Incontinence Group Specialised Trials Register (searched 1 February 2006).
SELECTION CRITERIA: Randomised and quasi-randomised trials of behavioural and/or cognitive interventions with or without other treatments for the management of faecal incontinence in children.
DATA COLLECTION AND ANALYSIS: Reviewers selected studies from the literature, assessed study quality, and extracted data. Data were combined in a meta-analysis when appropriate.
MAIN RESULTS: Eighteen randomised trials with a total of 1168 children met the inclusion criteria. Sample sizes were generally small. All studies but one investigated children with functional faecal incontinence. Interventions varied amongst trials and few outcomes were shared by trials addressing the same comparisons. Combined results of nine trials showed higher rather than lower rates of persisting symptoms of faecal incontinence up to 12 months when biofeedback was added to conventional treatment (OR 1.11 CI 95% 0.78 to 1.58). This result was consistent with that of two trials with longer follow-up (OR 1.31 CI 95% 0.80 to 2.15). In one trial the adjunct of anorectal manometry to conventional treatment did not result in higher success rates in chronically constipated children (OR 1.40 95% CI 0.72 to 2.73 at 24 months). In one small trial the adjunct of behaviour modification to laxative therapy was associated with a significant reduction in children's soiling episodes at both the three month (OR 0.14 CI 95% 0.04 to 0.51) and the 12 month assessment (OR 0.20 CI 95% 0.06 to 0.65).
AUTHORS' CONCLUSIONS: There is no evidence that biofeedback training adds any benefit to conventional treatment in the management of functional faecal incontinence in children. There was not enough evidence on which to assess the effects of biofeedback for the management of organic faecal incontinence. There is some evidence that behavioural interventions plus laxative therapy, rather than laxative therapy alone, improves continence in children with functional faecal incontinence associated with constipation.
Authors:
M Brazzelli; P Griffiths
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2006-04-19
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2006  
Date Detail:
Created Date:  2006-04-20     Completed Date:  2006-06-15     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD002240     Citation Subset:  IM    
Affiliation:
University of Edinburgh, Bramwell Dott Building, Department of Clinical Neurosciences, Western General Hospital, Crewe Road, Edinburgh, UK, EH4 2XU. m.brazzelli@ed.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Behavior Therapy / methods*
Biofeedback, Psychology
Child, Preschool
Cognitive Therapy / methods
Encopresis / psychology,  therapy*
Fecal Incontinence / psychology,  therapy*
Gastrointestinal Agents / therapeutic use
Humans
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents
Comments/Corrections
Update In:
Cochrane Database Syst Rev. 2011;(12):CD002240   [PMID:  22161370 ]
Update Of:
Cochrane Database Syst Rev. 2001;(4):CD002240   [PMID:  11687154 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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