NDLI: State of the Art Bowel Management for Pediatric Colorectal Problems: Anorectal Malformations.

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State of the Art Bowel Management for Pediatric Colorectal Problems: Anorectal Malformations.

Content Provider	Europe PMC
Author	Bokova, Elizaveta Svetanoff, Wendy Jo Lopez, Joseph J. Levitt, Marc A. Rentea, Rebecca M.
Editor	Cobellis, Giovanni Bindi, Edoardo
Copyright Year	2023
Abstract	Up to 79% of patients with anorectal malformations (ARMs) experience constipation and/or soiling after a primary posterior sagittal anoplasty (PSARP) and are referred to a bowel management program. We aim to report the recent updates in evaluating and managing these patients as part of the manuscript series on the current bowel management protocols for patients with colorectal diseases (ARMs, Hirschsprung disease, functional constipation, and spinal anomalies). The unique anatomic features of ARM patients, such as maldeveloped sphincter complex, impaired anal sensation, and associated spine and sacrum anomalies, indicate their bowel management plan. The evaluation includes an examination under anesthesia and a contrast study to exclude anatomic causes of poor bowel function. The potential for bowel control is discussed with the families based on the ARM index calculated from the quality of the spine and sacrum. The bowel management options include laxatives, rectal enemas, transanal irrigations, and antegrade continence enemas. In ARM patients, stool softeners should be avoided as they can worsen soiling.
Volume Number	10
PubMed Central reference number	PMC10217060
Issue Number	5
PubMed reference number	37238394
Journal	Children (Basel)
e-ISSN	22279067
DOI	10.3390/children10050846
Language	English
Publisher	MDPI
Publisher Date	2023-05-08
Access Restriction	Open
Rights License	Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). © 2023 by the authors.
Subject Keyword	bowel management anorectal malformation ARM imperforate anus antegrade enema Malone laxative enema constipation incontinence
Content Type	Text
Resource Type	Article
Subject	Pediatrics, Perinatology and Child Health

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