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Arch Dis Child 95:867-870 doi:10.1136/adc.2009.172973
  • Original article

Treatment of severe childhood constipation with restorative proctocolectomy

  1. Bruce Jaffray
  1. University of Newcastle upon Tyne, The Royal Victoria Infirmary, Newcastle upon Tyne, UK
  1. Correspondence to Mr Bruce Jaffray, Department of Paediatric Surgery, The Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK; bruce.jaffray{at}ncl.ac.uk
  • Accepted 27 December 2009
  • Published Online First 6 April 2010

Abstract

Objective To describe the clinical features of children with severe constipation and their outcome after restorative proctocolectomy.

Design Observational study and health status questionnaire using gastrointestinal quality of life score (GIQL).

Setting English regional paediatric surgery service.

Patients Five children were identified, with severe constipation, whose symptoms had not improved with either prolonged medical therapy or colonic lavage using an antegrade colonic enema procedure. All had required a stoma to resolve their constipation.

Intervention All underwent restorative proctocolectomy.

Results All children are stooling through their anus. The mean stool frequency is 6/day. None have daytime incontinence, and none require any further therapy for constipation. Complication rates have been low with no permanent morbidity. The mean GIQL 3 years following restorative proctocolectomy was 89 (SD 29).

Conclusions In highly selected cases, restorative proctocolectomy may allow resolution of the symptoms of severe constipation and avoid leaving a child with a permanent stoma.

Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Ethics approval Ethics approval was provided by the Clinical Ethic Committee, Newcastle upon Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle upon Tyne UK.

  • Patient consent Obtained.