{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:17:04Z","timestamp":1788437824138,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100011086","name":"NASPGHAN Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011086","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Chronic constipation (CC) and fecal incontinence (FI) are significant problems for pediatric patients. Transanal irrigation (TAI) is a therapy that effectively relieves symptoms in patients with disorders of gut\u2013brain interactions (DGBI) or organic CC\/FI. This mixed\u2010methods study aimed to identify predictive factors for TAI adherence and outcomes in pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Out of 151 screened patients, 63 were eligible for enrollment, with a 60.3% response rate and 97.3% survey completion. We analyzed adherence, symptom severity, quality of life (QOL), and manometry data from 38 patients who initiated TAI at Nemours Children's Hospital (2017\u20132023). Additionally, seven parents of noninitiating patients were interviewed to assess barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant differences were found in TAI\u2010related difficulties (pain, independence, and technical issues), though patients with DGBI etiologies reported slightly more psychological difficulties with TAI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.077). Adherent patients showed fewer CC symptoms and higher QOL compared to nonadherent patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) at the time of interview. Attention\u2010deficit\/hyperactivity disorder (ADHD), diagnosed in 42.1% of patients, was a significant predictor of nonadherence, with these patients reporting more severe symptoms and lower psychosocial scores. Manometry results did not predict outcomes, indicating a need for improved diagnostics. Barriers to TAI initiation included insurance challenges, fear of trauma, and logistical obstacles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with organic and DGBI CC\/FI experienced similar challenges using TAI. Adherence was associated with improved symptoms and QOL. ADHD was a significant predictor of nonadherence, underscoring the need for tailored interventions. Future research should focus on long\u2010term outcomes and strategies to enhance adherence, particularly for children with ADHD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70466","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:16:15Z","timestamp":1780053375000},"page":"265-273","source":"Crossref","is-referenced-by-count":0,"title":["Clinical, social, and motility factors influencing transanal irrigation response in pediatric patients"],"prefix":"10.1002","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8955-8724","authenticated-orcid":false,"given":"Stephanie","family":"Sutton","sequence":"first","affiliation":[{"name":"University of Central Florida\u2014College of Medicine Orlando Florida USA"},{"name":"Department of Graduate Medical Education Nemours Children's Health Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5711-9542","authenticated-orcid":false,"given":"Amanda L.","family":"Willis","sequence":"additional","affiliation":[{"name":"Department of Biomedical Research Nemours Children's Health Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2356-1401","authenticated-orcid":false,"given":"Juliana","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Department of Graduate Medical Education Nemours Children's Health Orlando Florida USA"},{"name":"Division of Gastroenterology Nemours Children's Hospital Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0398-5442","authenticated-orcid":false,"given":"Xiang","family":"Zhu","sequence":"additional","affiliation":[{"name":"University of Central Florida\u2014College of Medicine Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0933-9716","authenticated-orcid":false,"given":"Roberto A.","family":"Gomez\u2010Suarez","sequence":"additional","affiliation":[{"name":"University of Central Florida\u2014College of Medicine Orlando Florida USA"},{"name":"Division of Gastroenterology Nemours Children's Hospital Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2006.098335"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.12.034"},{"key":"e_1_2_8_4_1","volume-title":"Disorders of Gut Brain Interaction\u2010Definitions","author":"Anon","year":"2026"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v29.i8.1261"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000000266"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/pir.25.8.278"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.153.4.380"},{"key":"e_1_2_8_9_1","first-page":"0","article-title":"Behavioural and cognitive interventions with or without other treatments for the management of faecal incontinence in children","volume":"2011","author":"Brazzelli M","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(87)80345-7"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2013.08.006"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3102167"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2009.07.004"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2013.8"},{"key":"e_1_2_8_15_1","first-page":"287","article-title":"Transanal irrigation and intestinal transit time in children with myelomeningocele","volume":"65","author":"Marte A","year":"2013","journal-title":"Minerva Pediatr"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2014.234"},{"key":"e_1_2_8_17_1","first-page":"186","article-title":"Improvements in incontinence with self\u2010management in patients with anorectal malformations","volume":"26","author":"M\u00e4rzheuser S","year":"2016","journal-title":"Eur J Pediatr Surg"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13101"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.06.065"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-018-3860-4"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2018.08.013"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001236"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002785"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/954315"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/children8121174"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2019.04.003"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i11.2029"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpn3.12390"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236199"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001708"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-1819"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1377"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2008.032"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001695"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1580"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.2174\/138161210791959908"}],"container-title":["Journal of Pediatric Gastroenterology and Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpn3.70466","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jpn3.70466","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpn3.70466","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:52:45Z","timestamp":1788436365000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jpn3.70466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/jpn3.70466"],"URL":"https:\/\/doi.org\/10.1002\/jpn3.70466","archive":["Portico"],"relation":{},"ISSN":["0277-2116","1536-4801"],"issn-type":[{"value":"0277-2116","type":"print"},{"value":"1536-4801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]}}}