{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:37:03Z","timestamp":1783478223765,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,8,24]],"date-time":"2014-08-24T00:00:00Z","timestamp":1408838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Swedish Inheritance Fund"},{"name":"County Council of \u00d6sterg\u00f6tland"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim was to evaluate and compare different bowel regimes with regard to satisfaction, faecal incontinence and independence, and the relationship to quality of life among children with myelomeningocele (<jats:styled-content style=\"fixed-case\">MMC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A questionnaire, including the health\u2010related quality of life instrument Peds<jats:styled-content style=\"fixed-case\">QL<\/jats:styled-content> 4.0<jats:sup>\u2122<\/jats:sup>, was sent to all children aged seven to 16\u00a0years (n\u00a0=\u00a0172) with <jats:styled-content style=\"fixed-case\">MMC<\/jats:styled-content>, treated at two centres in Sweden and one in Norway. The three centres cover a third of the population in the two countries. The response rate was 62%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Parents of children (30%) using antegrade colonic enemas (<jats:styled-content style=\"fixed-case\">ACE<\/jats:styled-content>) reported higher satisfaction (p\u00a0=\u00a00.01) than the parents of those (47%) using transanal irrigation (TAI). The children reported no significant difference. Children and parents in the <jats:styled-content style=\"fixed-case\">ACE<\/jats:styled-content> group reported more complete evacuation of the bowels than the <jats:styled-content style=\"fixed-case\">TAI<\/jats:styled-content> group. No significant difference was found in faecal incontinence or independent toileting. The children (40%) who emptied their bowels independently reported a higher quality of life. Children using <jats:styled-content style=\"fixed-case\">TAI<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">ACE<\/jats:styled-content> spent around one hour on the toilet at every bowel emptying.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">TAI<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ACE<\/jats:styled-content> are effective treatments, but time\u2010consuming and difficult to perform independently. Higher parental satisfaction is obtained with <jats:styled-content style=\"fixed-case\">ACE<\/jats:styled-content>. Irrespective of method the children who can use the toilet independently report a higher quality of life, which makes efforts to support independence valuable.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.12756","type":"journal-article","created":{"date-parts":[[2014,7,21]],"date-time":"2014-07-21T15:42:07Z","timestamp":1405957327000},"page":"1159-1164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Independence does not come with the method \u2013 treatment of neurogenic bowel dysfunction in children with myelomeningocele"],"prefix":"10.1111","volume":"103","author":[{"given":"Peter","family":"Wide","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunilla","family":"Glad Mattsson","sequence":"additional","affiliation":[{"name":"Department of Clinical and 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