Nerve Stimulation helps Faecal Incontinence in Children

A recent study has shown nerve stimulation to be effective in treating constipation and faecal incontinence in children.

Lyon Wang, a third-year medical student at The Ohio State University and his colleagues used data from two patient registries for patients receiving sacral nerve stimulation who were younger than 18 years. The patients all had functional constipation. The children completed a questionnaire and follow-up encounters at 6 and 12 months. The participants all showed a significant reduction in faecal incontinence at 6 months and 12 months. The patients also reported reduction in hard stools. Results showed that children who had sacral nerve stimulation did have more frequent bowel movements, with 23% having three or less BMs per week.

This study comes after a related study in 2017, which showed promise that SNS could have long lasting effects on children with bowel problems. 25 children were treated with nerve stimulation for constipation that lasted at least 2 years. Those suffering from co-occurring faecal incontinence decreased dramatically from 92 percent to 20 percent.

Constipation and Faecal Incontinence

Constipation is actually one of the most common medical complaints in children, reported in 12 percent worldwide, claims Peter Lu, MD, an attending paediatric gastroenterologist. The condition is closely related to faecal incontinence, being both a cause and symptom of faecal incontinence. Constipation can cause the muscles in the rectum and anus to weaken. When these weaken, the ability to hold stool within the body also significantly weakens. Chronic constipation also often causes faecal impaction, in which faeces partially obstruct the bowel.  In severe constipation, hard masses of stool can form in the rectum and become too large. The muscles of the rectum and intestines can stretch and eventually become weaker, allowing watery stool from further up the digestive tract to move around the impacted stool and leak out. In some cases, chronic constipation can also cause severe nerve damage which leads to faecal incontinence.

What Occurs During Sacral Nerve Stimulation?

During electrical nerve stimulation, an electrical current is applied to one of the sacral nerves via an electrode. The electrode is attached to an implantable pulse generator which stimulates the nerves associated with bladder function. The procedure’s aim is to make the bladder work in a more controllable way, a bit like a pacemaker used for the heart. Sacral nerve stimulation is often recommended when a patient has severe, life limiting faecal incontinence which has not responded to conservative management.

 

Does your Child Have Faecal Incontinence and Constipation?

If your child begins to suffer from faecal incontinence, it is important to take them to the Doctor to rule out any serious causes. In most cases, faecal incontinence occurs due to chronic constipation. This is often due to not visitng the toilet frequently enough.

 

Signs your child has severe constipation:

  • Stomachache
  • Not eating much despite being hungry
  • Painful stools and fear of passing bowel movements
  • Having faecal accidents

 

You can take the following actions if your child has faecal incontinence and constipation:

  • Ask for a subscription of enemas or a drink to clean out the bowel
  • Teach your child bowel habits, ensuring they have regular bowel movements. Doctors recommend encouraging your child to sit on the toilet four times each day.
  • Encourage your child to eat more high-fiber foods
  • Encourage more liquid consumption. It is important to ensure your child drinks plenty of water each day to prevent constipation.

Read our Tips and Guidance on Managing Urinary Incontinence in Children

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