Title : A pilot study of the correlation between dietary fiber and water intake and successful bowel management after surgery for hirschsprung's disease and anorectal malformation
Abstract:
Hirschsprung’s Disease and Anorectal malformations each represent 1 in 5,000 births in the pediatric population. These conditions require surgical intervention in the neonatal period with postoperative challenges including fecal incontinence, constipation, and affected quality of life. Many of these patients utilize a “bowel management” program, which refers to mechanically preparing the colon via enemas and irrigations to have better bowel control and improved quality of life. Most studies evaluating the impact of dietary fiber do not include this population or how their quality of life may be impacted. The primary objective: increased fiber intake might have a positive impact improved constipation as evidence by Cleveland clinic score in the bowel management population. Secondary objective: measure the quality of life of the bowel management population. This is a case-control study design. A total of 24 patients (12 cases vs 12 control) were recruited from the pediatric surgery department. Inclusion Criteria: Male or female patients with diagnosed HD or AMF, aged 2-10 years old. Exclusion Criteria: patients diagnosed with Neurofibromatosis, Waardenburg syndrome, Down syndrome, and Multiple endocrine neoplasia type II. Dietary recall (3 days) was obtained and analyzed via the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24). Constipation was evaluated via the Cleveland Clinic constipation scoring system. Quality of life was examined using the Pediatric Quality of Life Inventory™ (PedsQL™). Result shows children with Hirschsprung’s Disease and Anorectal malformations had significant high constipation score comparing to the control (p=<0.001). The average and adequate fiber and water intake were similar between the two groups. This study was not able to determine correlation between adequate fiber and water intake and high constipation score. Furthermore, the study group had significant low scores in the dimensions of the quality of life in comparison with the control. Finally, no correlation detected between high fiber intake and relatively high constipation score. The quality of life was adversely affected by Hirschsprung’s Disease and Anorectal malformations
.Audience Take Away:
- Shedding the light on the role of fiber on the management of HD and AMF
- Sharing the current gap in the practice/knowledge
- Clinical will learn about the current knowledge gap in the correlation of fiber and HD and AMF. Yes, the current finding might be used by other clinician/ researcher to conduct extending research
