• A project run by The Royal London Hospital.
  • To be implemented in the children’s department of The Royal London Hospital.
  • Aiming to improve quality of life and outcomes for infants, children and adolescents with faecal incontinence and constipation.
  • Involves offering patients a comprehensive assessment, including many of the psychological, physical and physiological components of the condition, in order to target treatment and optimise quality of life for these patients.

Constipation, with or without faecal incontinence, is one of the 10 most common problems seen by general paediatricians, and affects 5–30% of children. Faecal incontinence is distressing and embarrassing for children, and has a major impact on quality of life. This group of children often have poor outcomes, caused by a debilitating set of symptoms, including pain, rectal bleeding, poor appetite, low self-esteem, and reduced school attendance and educational achievement.

The paediatrics team at The Royal London Hospital is carrying out an innovative project aimed at improving and optimising quality of life for these children. A comprehensive package of assessment will be implemented, including assessment of quality of life, bowel function and psychological wellbeing, anorectal physiology and endoanal ultrasound, and imaging.

The results will be evaluated by a multidisciplinary team, including a paediatric surgeon, paediatric gastroenterologist and clinical psychologist, so that a unique, targeted management plan can be formulated for every patient. Interventions will include education, talking therapies, bowel re-training, neuromodulation, transanal irrigation and surgery.

There will be 30 children recruited initially, followed by two to six patients a week, so that a total of around 50 children will be involved in the project.

The impact of the interventions will be measured and monitored through regular assessment, and evaluated against the baseline scores. It is anticipated that significant improvements will be seen over a 12-month period.

The service will take place in the children’s outpatient department, playrooms, wards and operating theatres of The Royal London Hospital, and the homes of patients and families.

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