Abstract
ObjectiveSurgical treatment of anorectal malformations (ARMs) and Hirschsprung's disease (HD) leads to alterations in bowel habits and fecal incontinence, with consequent quality of life impairment. The objectives were to create and validate a Questionnaire for the Fecal Incontinence Index (FII) based on the Holschneider score, as well as a Questionnaire for the Assessment of Quality of Life Related to Fecal Incontinence in Children and Adolescents (QQVCFCA), based on the Fecal Incontinence Quality of Life. MethodsThe questionnaires were applied to 71 children submitted to surgical procedure, in two stages. Validity was tested by comparing the QQVCFCA and a generic quality of life questionnaire (SF-36), and between QQVCFCA and the FII. A group of 59 normal children was used as control. ResultsAt two stages, 45.0% (32/71) and 42.8% (21/49) of the patients had fecal incontinence. It was observed that the QQVCFCA showed a significant correlation with the SF-36 and FII (Pearson's correlation 0.57), showing that the quality of life is directly proportional to improvement in fecal incontinence. Quality of life in patients with fecal incontinence is still globally impaired, when compared with control subjects (p<0.05, Student's t-test). There were also significant differences between the results of children with ARMs and children with HD. ConclusionsQQVCFCA and FII are useful tools to assess the quality of life and fecal incontinence in these groups of children. Children with ARMs submitted to surgical procedure and HD have similar quality of life impairment.
Highlights
Anorectal malformations and Hirschsprung’s disease are congenital disorders affecting approximately 1:5000 live births
The Questionnaire for the Fecal Incontinence Index (FII), based on the Clinical Evaluation of Fecal Continence (Holschneider Criteria)[3] and the Questionnaire for the Assessment of Quality of Life Related to Fecal Continence in Children and Adolescents (QQVCFCA), based on the Fecal Incontinence Quality of Life (FIQL) were created.[4]
FII, fecal incontinence index; QQVCFCA, questionnaire for the assessment of quality of life related to fecal incontinence in children and adolescents; LS, lifestyle; BEH, behavior; DEP, depression; and EMB, embarrassment
Summary
Anorectal malformations and Hirschsprung’s disease are congenital disorders affecting approximately 1:5000 live births. Surgical correction should be done early and the main objective is the anatomical reconstruction of structures with normal bowel habits.[1] constipation and/or fecal incontinence are frequent, with important consequences on personal, social, and professional spheres that may reflect in adulthood. Patients may suffer strong negative impact on quality of life (QoL). QoL is defined by the World Health Organization as ‘‘the individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns’’.2. QoL is a subjective data comprising several areas and should be evaluated individually and based on the expectations of patients and their relatives QoL is defined by the World Health Organization as ‘‘the individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns’’.2 QoL is a subjective data comprising several areas and should be evaluated individually and based on the expectations of patients and their relatives
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