Social Morbidity in Relation to Bowel Functional Outcomes and Quality of Life in Anorectal Malformations and Hirschsprung's Disease
Social Morbidity in Relation to Bowel Functional Outcomes and Quality of Life in Anorectal Malformations and Hirschsprung's Disease
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DOI：
10.1055/s-0037-1607356
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发表时间：
2018-12-01
影响因子：
1.8
通讯作者：
Rintala, Risto J.
中科院分区：
文献类型：
--
作者：
Kyrklund, Kristiina;Neuvonen, Malla I.;Rintala, Risto J.
背景肛门直肠畸形（ARMs）和先天性巨结肠（HD）是与不同程度大便失禁相关的慢性肠道疾病。我们的目的是讨论与ARMs和HD的社会发病率在长期的当代状态后，当代treatment.Materials和方法的肠功能的结果，我们最近的机构系列adultoodwere审查和比较forARMs和HD。Rintala评分被用来评估肠功能，包括对疾病社会影响的评估。在这项研究中，社会成果inourpopulation的患者与ARMs andHD进行了专门分析有关的调查功能的结果，我们以前收集的数据生活质量（QoL）和目前的literature.Results轻度ARMs与社会发病率的风险最小，符合良好的结果。在严重的ARMs和HD中，在研究的所有年龄组中，社会问题的报告都是稳定的。在53 - 89%的社会问题患者中存在粪便控制领域的损害，包括高达39%的频繁症状（> 1/周）。非自愿气体泄漏导致15%至27%的社会发病率。与生活质量数据的比较表明，在儿童时期经历的社会发病率可能会继续影响生活质量的情感领域在以后的生活中，尽管改善肠功能的adult.Conclusion患者严重的ARMs和HD的风险，尽管当代手术治疗的肠功能损害的社会限制。然而，在成年期的生活质量结果可能更多地影响从儿童形成的疾病自我认知比疾病特异性因素。减少与这些疾病相关的心理发病率的策略，包括父母从一开始的参与，可能会改善结果。
Background Anorectal malformations (ARMs) and Hirschsprung's disease (HD) are chronic bowel conditions associated with varying degrees of fecal incontinence. We aimed to discuss the contemporary status of social morbidity associated with ARMs and HD in the long term after contemporary treatments.Materials and Methods The bowel functional outcomes of our recent institutional series upto adulthoodwere reviewed and compared forARMs and HD. The Rintala scorewas used to evaluate bowel function, which includes an assessment of the social effects of the condition. In this study, the social outcomes inourpopulation of patients withARMs andHD were specifically analyzed in relation to the surveyed functional outcomes, our previously collected data on quality of life (QoL) and the current literature.Results Mild ARMs were associated with a minimal risk of social morbidity consistent with good outcomes. In severe ARMs and HD, social problems were reported steadily among all age groups studied. Impairment of domains of fecal control were present among 53 to 89% of patients with social problems, including frequent symptoms (> 1/ week) in up to 39%. Involuntary gas leakage contributed to social morbidity in 15 to 27%. Comparison with QoL data suggested that social morbidity experienced during childhood may continue to affect emotional domains of QoL in later life, despite improvements in bowel function by adulthood.Conclusion Patients with severe ARMs and HD are at risk of social restrictions from impairment of bowel function despite contemporary surgical treatments. However, the QoL outcomes in adulthood may be more influenced by self-perceptions of illness formed from childhood than disease-specific factors. Strategies to reduce the psychological morbidity associated with these conditions that includes parental involvement from the outset may improve outcomes.