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Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 14, 2007; 13(22): 3101-3105
Published online Jun 14, 2007. doi: 10.3748/wjg.v13.i22.3101
Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation
Marcel Cazemier, Richelle JF Felt-Bersma, Chris JJ Mulder
Marcel Cazemier, Richelle JF Felt-Bersma, Chris JJ Mulder, Department of Gastroenterology and Hepatology, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam,
Author contributions: All authors contributed equally to the work.
Correspondence to: Marcel Cazemier, Department of Gastro-enterology and Hepatology, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands.m.cazemier@vumc.nl
Telephone: +31-20-4440613 Fax: +31-20-4440554
Received: January 12, 2007
Revised: January 25, 2007
Accepted: January 31, 2007
Published online: June 14, 2007
Abstract

AIM: To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation (RCI) in patients with fecal incontinence or constipation.

METHODS: Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire.

RESULTS: Of the 201 patients (93 adults, 108 children), 101 (50%) responded. Adults: anal plugs (8), five stopped immediately, one stopped after 20 mo and two used it for 12-15 mo. RCI (40, 28 fecal incontinence, 12 constipation), 63% are still using it (mean 8.5 years), 88% was satisfied. Younger adults (< 40 years) were more satisfied with RCI (94 % vs 65%, P = 0.05). Children: anal plugs (7), 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI (26 fecal incontinence, 22 constipation), 90% are still using it (mean time 6.8 years) and felt satisfied. Children tend to be more satisfied (P = 0.001). Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation.

CONCLUSION: RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.

Keywords: Fecal incontinence; Constipation; Retrograde colonic irrigation; Anal plug