Transanal Irrigation in Children: Treatment Success, Quality of Life, Adherence, Patient Experience, and Independence

Desiree F. Baaleman, Carrie A. M. Wegh, Maxime T. A. Hoogveld, Marc A. Benninga, Ilan J. N. Koppen

Research output: Contribution to journalReview articleAcademicpeer-review

4 Citations (Scopus)


Objectives: To investigate the clinical effectiveness and patient experience of transanal irrigation (TAI) in children with constipation or fecal incontinence. Methods: Combined retrospective and cross-sectional study including pediatric patients who used a Navina TAI system. We retrospectively collected baseline characteristics and data on treatment success at 1- and 6-month follow-up (FU). Treatment success was defined as defecating at least 3 times per week and having less than 1 episode of fecal incontinence per week. We cross-sectionally assessed health-related quality of life (HRQoL), treatment adherence, treatment satisfaction (Treatment Satisfaction Questionnaire for Medication [TSQM]), illness perceptions, medication beliefs, and patient empowerment with validated questionnaires. Results: Thirty-four patients were included (median age at start TAI: 11 years old [range, 6-18]), 32 in the retrospective review, and 26 in the cross-sectional survey (median of 3 years after initiation). Most patients were diagnosed with functional constipation (n = 26; 76%) or a neurogenic bowel disorder (n = 6; 18%). Treatment success rates significantly improved at each FU compared with baseline (baseline: 4/25 [16%]; 1-month FU: 12/16 [75%], P = 0.008; 6-month FU: 11/18 [61%], P = 0.016; cross-sectional FU: 13/26 [50%], P = 0.008). HRQoL scores were high (PedsQL median, 73 [IQR, 54-85]). Adherence (defined as Medication Adherence Report Scale [MARS] ≥ 23) was low (36%), whereas TSQM effectiveness scores were high (median, 69 [IQR, 47-86]). The majority of children (61%) reported an increase in independence since TAI treatment. Patient empowerment (GYPES) levels were similar to those reported in children with other chronic conditions. Conclusions: TAI with a Navina system is an effective bowel management system for children with intractable constipation or fecal incontinence.
Original languageEnglish
Pages (from-to)166-172
Number of pages7
JournalJournal of pediatric gastroenterology and nutrition
Issue number2
Publication statusPublished - 1 Aug 2022


  • child
  • constipation
  • fecal incontinence
  • transanal irrigation

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