Biopsychosocial treatment of defecation problems in children with anal atresia: a retrospective study |
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Authors: | E M van Kuyk A T M Brugman-Boezeman M Wissink-Essink R S V M Severijnen C Festen G Bleijenberg |
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Institution: | (1) Department of Medical Psychology, University Hospital Nijmegen, Nijmegen, The Netherlands, NL;(2) Department of Pediatric Physical Therapy, University Hospital Nijmegen, Nijmegen, The Netherlands, NL;(3) Department of Pediatric Surgery, University Hospital Nijmegen, Nijmegen, The Netherlands, NL;(4) University Hospital Nijmegen, 118 Medical Psychology, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands, NL |
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Abstract: | In a retrospective study, we examined whether multidisciplinary treatment based on a biopsychosocial approach and carried
out by a pediatric surgeon, a child psychologist, and a pediatric physiotherapist is successful in reducing defecation problems
(incontinence and/or constipation) in children with operated anal atresia (AA) (mean age 6.9 ± 4.01 years). A second question
was whether this treatment is successful in young children aged 2–5 years. The multidisciplinary approach consisted of standard
medical treatment and a behavioral program to teach children and their parents adequate defecation behavior including an adequate
straining technique. Forty-three children aged 2–16 years were included: 27 boys and 16 girls with AA, of whom 26 had high
or intermediate and 17 low AA. Besides continence and constipation, defecation behavior and straining technique were evaluated.
The children improved significantly during treatment in all aspects of defecation. No differences in effect of treatment were
found between young children (2–5 years) and older ones, so this treatment seems to be equally effective in both age groups.
This study demonstrates that both somatic and behavioral factors contribute to the persistence of chronic defecation problems.
It is concluded that treatment of these problems in patients with operated AA should include behavioral modification techniques.
Accepted: 1 February 2000 |
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Keywords: | Multidisciplinary treatment Anal atresia Biopsychosocial approach Incontinence Constipation |
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