The goal of this clinical trial is to compare combination therapy with low volume trans anal irrigation (TAI) and oral laxatives to monotherapy with oral laxatives in children with functional constipation and fecal incontinence. The main questions it aims to answer are: * Can more efficient treatment be achieved with aforementioned combination therapy? * Does the well-being of the children change, when they are well treated for their symptoms? * Is low-volume trans anal irrigation a tolerable treatment method for children? Participants will be randomized into 2 groups, where one group is treated with current standard treatment of PEG (oral laxatives), and the other group is treated with PEG + daily low volume TAI.
Functional constipation and retentive fecal incontinence is a prevalent health issue in children. The current standard treatment regimen in Denmark consists mainly of behavioral interventions and oral laxative treatment. This treatment leaves a large group of non-responders. Suffering from constipation and fecal incontinence has a negative impact on well-being in children, wherefore treatment of this condition should be improved. Earlier literature shows that trans anal irrigation (TAI) is an effective means of managing these symptoms, both in children and adults. However, conventional high volume TAI is time consuming (up to 45 minutes-an hour daily) and a cause of discomfort, or even pain. This can lead to low compliance and treatment failure. Low volume TAI has the potential of bringing about all the positive effects of TAI, but with less time consumption (only few minutes daily) and less discomfort. In this clinical trial, we will compare how children with functional constipation and fecal incontinence respond to treatment with 1) oral laxatives (PEG) alone versus 2) PEG and low volume TAI with the MiniGo-irrigation system. The intervention period is 6 weeks, and the treatment takes place at home.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
To be taken orally on a daily basis throughout the study period (6 weeks) in an adjusted dose.
To be administered rectally on a daily basis throughout the study period (6 weeks) along with an adjusted dose of polyethylene glycols
Aalborg Universitetshospital
Aalborg, Vælg Provins, Denmark
Aarhus Universitetshospital
Aarhus, Vælg Provins, Denmark
Regionshospitalet Gødstrup
Herning, Vælg Provins, Denmark
Fecal incontinence episodes
Seeks to measure if there is any significant difference in the amount of fecal incontinence episodes between the two groups after the study period
Time frame: 6 weeks
Well-being
Seeks to measure if the well-being of the children changes when their symptoms are treated. Measured using the WHO-5-well being index
Time frame: 6 weeks
Tolerability of low volume TAI
Seeks to investigate whether low volume TAI is tolerated by the children, or if the system causes pain or discomfort.
Time frame: 6 weeks
Constipation symptoms
Seeks to investigate whether constipation symptoms (based on ROME-IV criteria) change after treatment
Time frame: 6 weeks
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