Development, reliability and validation of a neurogenic bowel dysfunction score in pediatric patients with spina bifida

2014 ◽  
Vol 35 (2) ◽  
pp. 212-217 ◽  
Author(s):  
Maryellen S. Kelly ◽  
Margaret Hannan ◽  
Brenda Cassidy ◽  
Guy Hidas ◽  
Blake Selby ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Pediatric Patients ◽  
Bowel Dysfunction ◽  
Neurogenic Bowel

scholarly journals Effects of Transanal Irrigation on Gut Microbiota in Pediatric Patients with Spina Bifida

2021 ◽  
Vol 10 (2) ◽  
pp. 224
Author(s):  
Akira Furuta ◽  
Yasuyuki Suzuki ◽  
Ryosuke Takahashi ◽  
Birte Petersen Jakobsen ◽  
Takahiro Kimura ◽  
...  
Keyword(s):  
Spina Bifida ◽  
16S Rrna ◽  
Gut Microbiota ◽  
Pediatric Patients ◽  
Host Immune System ◽  
Healthy Controls ◽  
Transanal Irrigation ◽  
Rrna Sequencing ◽  
Before And After ◽  
Neurogenic Bowel

Recent studies using 16S rRNA-based microbiota profiling have demonstrated dysbiosis of gut microbiota in constipated patients. The aim of this study was to investigate the changes in gut microbiota after transanal irrigation (TAI) in patients with spina bifida (SB). A questionnaire on neurogenic bowel disfunction (NBD), Bristol scale, and gut microbiota using 16S rRNA sequencing were completed in 16 SB patients and 10 healthy controls aged 6–17 years. Then, 11 of 16 SB patients with moderate to severe NBD scores received TAI for 3 months. Changes in urine cultures were also examined before and after the TAI treatments. In addition, correlation of gut microbiota and Bristol scale was analyzed. Significantly decreased abundance in Faecalibacterium, Blautia and Roseburia, and significantly increased abundance in Bacteroides and Roseburia were observed in the SB patients compared with controls and after TAI, respectively. The abundance of Roseburia was significantly correlated positively with Bristol scale. Urinary tract infection tended to decrease from 82% to 55% after TAI (p = 0.082) despite persistent fecal incontinence. Butyrate-producing bacteria such as Roseburia play a regulatory role in the intestinal motility and host immune system, suggesting the effects of TAI on gut microbiota.

Who is managing the bowels? A survey of clinical practice patterns in spina bifida clinics

2021 ◽  
pp. 1-5
Author(s):  
Maryellen S. Kelly ◽  
Jennifer Stout ◽  
John S. Wiener
Keyword(s):  
Spina Bifida ◽  
Nurse Practitioners ◽  
Practice Patterns ◽  
Response Rate ◽  
Bowel Dysfunction ◽  
Rehabilitation Medicine ◽  
The United States ◽  
Medical Specialties ◽  
Dissemination Of Research ◽  
Neurogenic Bowel

PURPOSE: Neurogenic bowel dysfunction (NBD) affects 80% of individuals with spina bifida. Performing and disseminating research on NBD to reach the appropriate audience is difficult given the variability among medical specialties managing NBD. This study aimed to identify which medical specialties and types of providers are currently managing NBD in the United States. METHODS: A survey was developed and sent to 75 spina bifida clinics. Surveys queried which specialty was primarily responsible for medical and surgical management of NBD and any others that assist in NBD care. The license and certification level of the providers were collected. Descriptive statistics were performed to describe the results. RESULTS: Response rate was 68%. Urology was the leading specialty primarily responsible for NBD management (39%) followed by rehabilitation medicine and developmental pediatrics (22% and 20%, respectively). Physicians were the primary providers of care followed by nurse practitioners (54% vs 31%). Urology performs 65% of NBD surgeries. CONCLUSION: Multiple specialties and providers are involved in NBD management with variation among clinics. Development of improved NBD care should include a spectrum of specialties and providers. Dissemination of research should be aimed at multiple specialty groups.

scholarly journals Neurogenic bowel treatments and continence outcomes in children and adults with myelomeningocele

2020 ◽  
Vol 13 (4) ◽  
pp. 685-693
Author(s):  
Maryellen S. Kelly ◽  
John S. Wiener ◽  
Tiebin Liu ◽  
Priya Patel ◽  
Heidi Castillo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Spina Bifida ◽  
Research Collaboration ◽  
Statistical Tests ◽  
Private Insurance ◽  
Bowel Dysfunction ◽  
Individual Characteristics ◽  
Treatment Modalities ◽  
Inclusion Criteria ◽  
Neurogenic Bowel

PURPOSE: Neurogenic bowel dysfunction (NBD) is a common comorbidity of myelomeningocele (MMC), the most common and severe form of spina bifida. The National Spina Bifida Patient Registry (NSBPR) is a research collaboration between the CDC and Spina Bifida Clinics. Fecal continence (continence) outcomes for common treatment modalities for NBD have not been described in a large sample of individuals with MMC. NSBPR patients with MMC and NBD were studied to determine variation in continence status and their ability to perform their treatment independently according to treatment modality and individual characteristics. METHODS: Continence was defined as < 1 episode of incontinence per month. Eleven common treatments were evaluated. Inclusion criteria were established diagnoses of both MMC and NBD, as well as age ⩾ 5 years (n= 3670). Chi-square or exact statistical tests were used for bivariate analyses. Logistic regression models were used to estimate the odds of continence outcomes by age, sex, race/ethnicity, level of motor function, and insurance status. RESULTS: At total of 3670 members of the NSBPR met inclusion criteria between November 2013 and December 2017. Overall prevalence of continence was 45%. Prevalence ranged from 40–69% across different treatments. Among continent individuals, 60% achieved continence without surgery. Antegrade enemas were the most commonly used treatment and had the highest associated continence rate. Ability to carry out a treatment independently increased with age. Multivariable logistic regression showed significantly higher odds of continence among individuals aged ⩾ 12 years, female, non-Hispanic white, and with private insurance.

INTRAVESICAL ELECTRICAL STIMULATION IMPROVES NEUROGENIC BOWEL DYSFUNCTION IN CHILDREN WITH SPINA BIFIDA

2004 ◽  
Vol 171 (6 Part 2) ◽  
pp. 2648-2650 ◽  
Author(s):  
SANG WON HAN ◽  
MYOUNG JIN KIM ◽  
JANG HWAN KIM ◽  
CHANG HEE HONG ◽  
JAE WOOK KIM ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Spina Bifida ◽  
Bowel Dysfunction ◽  
Neurogenic Bowel

scholarly journals Bowel function and care: Guidelines for the care of people with spina bifida

2020 ◽  
Vol 13 (4) ◽  
pp. 491-498
Author(s):  
Patricia Beierwaltes ◽  
Paige Church ◽  
Tiffany Gordon ◽  
Lusine Ambartsumyan
Keyword(s):  
Spina Bifida ◽  
Bowel Function ◽  
Bowel Dysfunction ◽  
Secondary Complications ◽  
Social Opportunities ◽  
Care Guidelines ◽  
Children And Young Adults ◽  
Evidence Based Guidelines ◽  
Neurogenic Bowel

PURPOSE: Bowel dysfunction, such as constipation and fecal incontinence, has a significant impact on health, activities of daily living, and quality of life among people with spina bifida. Secondary complications may result from bowel dysfunction and include urologic dysfunction, loss of skin integrity, shunt (hydrocephalus) function, as well as loss of social opportunities and employability. METHODS: Using a consensus building methodology, the guidelines for management of bowel dysfunction in spina bifida were written by experts in the field of spina bifida and bowel function and care. RESULTS: The evidence-based guidelines are presented in table format and provide age-specific recommendations to achieve fecal continence without constipation. Recommended treatments are presented from least to most invasive options. Literature supporting the recommendations and the interval research published to date is also presented. CONCLUSION: These guidelines present a standardized approach to management of bowel dysfunction in spina bifida. Bowel management in children and young adults with spina bifida is limited by variability in clinical practice and paucity of robust research in neurogenic bowel. Collaborative multi-institutional efforts are needed to overcome research barriers and provide innovative solutions.

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