Clinical utility of the Pediatric Bowel Management Scoring Tool in guiding management of childhood constipation-a prospective, multicenter study.

To evaluate the clinical utility of the Pediatric Bowel Management Scoring Tool (PBMST) by assessing its association with healthcare practitioner (HCP) treatment decisions and patient-reported quality of life in children with constipation using transanal irrigation (TAI). A multicenter prospective cohort study was conducted in 121 children (4-18 years) with functional or organic constipation, either newly initiating (NTP) or currently receiving (CTP) TAI. The PBMST and PedsQL™ 4.0 quality of life questionnaires were completed at baseline and one-month follow-up. PBMST outcomes range from 0 to 22; higher scores indicate worse bowel management. HCPs, blinded to PBMST scores, classified treatment strategies as adequate, sub-optimal, or inadequate. Associations between PBMST scores and HCP treatment decisions were analyzed using multiple linear regression, adjusting for age, sex, and participant type (NTP or CTP). Correlations between PBMST and PedsQL™ scores, as well as associations between TAI adherence, duration of TAI use, and predictors of high adherence (MARS-5 ≥ 23), were examined. Survey completion rates were 93% at baseline and 88% at follow-up. Higher PBMST scores were associated with HCP-rated inadequate treatment (B = 2.44, SE = 0.72, p = 0.001), independent of age, sex, and participant type (NTP or CTP). PBMST scores were negatively correlated with PedsQL™ scores (r =  - 0.47, p < 0.001). No significant associations were found between adherence and TAI duration or PBMST scores. Lower adherence to TAI was associated with older age and participants reporting that TAI was too time-consuming.Conclusion: The PBMST is a valid tool reflecting symptom severity, correlating with HCP treatment decisions and patient-reported quality of life in children with functional or organic constipation using TAI.