John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Management of bowel dysfunction in patients with Spina Bifida: what is the place of the gastroenterologist? Volume 23, issue 10, Décembre 2016

Figures

  • Figure 1
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Tables

Authors
1 CHRU Pontchaillou,
service des maladies de l’appareil digestif,
Université de Rennes 1,
2 rue Henri le Guillou,
35033 Rennes cedex,
France
2 CHRU Pontchaillou,
service d’explorations fonctionnelles digestives,
Université de Rennes 1,
Rennes,
France
3 INSERM U1235,
Université de Nantes,
Nantes,
France
4 CIC 1414,
INPHY,
Université de Rennes 1,
Rennes,
France
5 CHRU Pontchaillou,
service d’urologie,
Rennes,
France
6 CHRU Pontchaillou,
centre référence national maladies rares Spina Bifida,
Rennes,
France
7 CHRU Pontchaillou,
service de médecine physique et rééducation,
Rennes,
France
* Tirés à part

Spina bifida is a rare birth defect due to incomplete closure of the neural tube. Spina Bifida is associated with multiple functional impairments: patients with Spina Bifida are multihandicapped and require a multidisciplinary approach. Bowel dysfunction such as constipation and fecal incontinence is the second most common major concern in patients with Spina Bifida behind lower urinary tract dysfunction. In contrast to the well-established care of urological disorders, bowel dysfunction lacks evidence to assist in physician decision-making. Neurological level is not associated with bowel dysfunction highlighting the importance of the initial evaluation. In case of failure of the first line treatment, anorectal manometry and colonic transit time can be useful. The management of bowel dysfunction is based on abdominal massages, softeners, anal digitation to defecate, biofeedback and retrograde/anterograde enemas.