Evidence map›Paper›PMID 36107238›Full record

ArticlePediatric surgery international2022

The success rate of antegrade enemas for the management of idiopathic constipation.

Marina L Reppucci, Margo M Nolan, Emily Cooper, Lea A Wehrli, Julie Schletker, Jill Ketzer, Alberto Peña, Andrea Bischoff, Luis De la Torre

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Article in Pediatric surgery international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.2field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Marina L ReppucciInternational Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA.
Margo M NolanInternational Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA.
Emily CooperResearch in Outcomes in Children's Surgery, Children's Hospital Colorado, Aurora, CO, USA.
Lea A WehrliInternational Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA.
Julie SchletkerInternational Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA.
Jill KetzerInternational Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA.
Alberto PeñaInternational Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA.
Andrea BischoffInternational Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA.
Luis De la TorreInternational Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA. luis.delatorre@childrenscolorado.org.
Children's Hospital Colorado · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMost patients with idiopathic constipation achieve daily voluntary bowel movements with stimulant laxatives after a "Structured Bowel Management Program" (BMP). A small percentage require rectal enemas. One week in a BMP to find the right enema recipe results in a success rate great than 95%. Once the enema is radiologically and clinically effective, antegrade continent enema procedures (ACE) can afford patients an alternative route of enema administration. This study summarized the outcomes of children with idiopathic constipation who receive antegrade enemas (AE) with or without a prior BMP.

methodsThis was a single institution, retrospective cohort study of children with idiopathic constipation who underwent ACE procedures indicated by different providers from 2015-2020. We categorized the outcomes with AE after the ACE procedure as: "successful outcome" when the AE produced a daily bowel movement, no involuntary bowel movements, and no more fecal impactions, "unsuccessful outcome" was defined when the patient continued having involuntary bowel movements or fecal impaction requiring cleanouts despite a daily AE, and "unnecessary outcome" was defined when the patient was no longer doing AE, but had daily bowel movements, and no involuntary bowel movements or fecal impactions.

resultsThirty-eight children with idiopathic constipation had an ACE. The most frequent indication for ACE was a failure of medical treatment. The most common medical treatment was polyethylene glycol. Before ACE, 34 (89%) patients did not have a BMP; 18 patients were on rectal enemas and 16 on laxatives. All four with BMP (100%) had a successful rectal enema. After ACE, 12 (31%) patients had successful antegrade enemas, including the four with previous successful BMP with rectal enemas. Twenty patients (52%) had unsuccessful antegrade enemas, and in 6 (15%), the ACE was unnecessary (Fig. 1).

conclusionUsing antegrade enemas without a previously successful formula for rectal enemas has resulted in a high rate of unsuccessful and unnecessary procedures. BMP for children with idiopathic constipation who needs rectal enemas offers a high possibility to find the proper rectal enema recipe and ensures higher rates of successful AE.

Indexed as

Fecal IncontinenceLaxativesChildConstipationEnemaHumansPolyethylene GlycolsRetrospective StudiesTreatment OutcomeLaxativesPolyethylene GlycolsAntegrade Continent EnemaIdiopathic constipationMalone procedurerectal enema

Identifiers

PMID36107238
OpenAlexW4295907480

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.