The outcomes of a structured bowel management programme on childhood functional constipation: a retrospective pre - post intervention study.

AIM: The purpose of this study was to describe and evaluate the effectiveness of a six-month structured bowel management programme (SBMP) for children with therapy-resistant functional constipation (FC).

METHOD: A retrospective review of medical records with a pre-post design was conducted at an outpatient paediatric clinic in Sweden. Bowel frequency, stool form, faecal incontinence, and abdominal pain were compared before and after the intervention. Predictive factors for successful discharge and duration of care through long-term follow-up were calculated.

RESULTS

Of the 142 children enrolled in the SBMP, 132 completed the programme. Despite previous FC therapy resistance, the SBMP achieved a treatment success rate of 44 % within 6 months, and 58 % after 12 months. The need for additional contacts beyond those scheduled and persistent faecal leakage were significant predictors of non-recovery. Long-term follow-ups indicate that after 2 years of care, approximately 80 % of the children achieved recovery.

CONCLUSION

This study highlights the effectiveness of the SBMP in managing therapy-resistant FC in children at a general outpatient paediatric clinic, while also emphasising the necessity of long-term follow-up for sustainable results.

IMPLICATIONS TO PRACTICE: The results suggest that a structured care programme like the SBMP helps set realistic expectations and ensures consistent quality of care for children with FC, despite the severity and complexities involved.