Journal of Pediatric Research and Neonatal Care

Behavioral and Psychiatric Associations with Rectal Prolapse in Older Children

Ashlyn E Whitlock, Lorena Rincon-Cruz, Lauren Mednick, Farokh R Demehri, Belinda Dickie, Prathima Nandivada*

Boston Children’s Hospital, USA

Abstract

Background: Rectal prolapse (RP) in the pediatric population is a rare yet challenging condition. This study aimed to characterize the mental and behavioral health disorder (MBHD) history in our cohort of RP patients and compare their outcomes.

Methods: This retrospective cohort study, conducted at a single center, reviewed all patients undergoing surgical evaluation for RP between 2016 and 2021.

Results: Among 56 identified patients, 30 met inclusion criteria, with 16 (53.3%) having documented MBHD. Patients with MBHD were notably older (14.4 vs 9.4 years, p=0.027) and exhibited higher rates of constipation (94% vs 17%, p=0.05). They also experienced a significantly longer duration of medical management before intervention compared to those without MBHD (216 vs 57 days, p=0.046). Notably, a higher proportion of patients with MBHD underwent operative intervention for rectal prolapse (50% vs 14.2%, p=0.019).

Conclusions: Pediatric patients with rectal prolapse demonstrate a considerable prevalence of MBHD. Despite prolonged periods of medical management, a substantial number of these patients ultimately require operative intervention.

Keywords:

Rectal prolapse; Neurologic disorders; Cystic fibrosis; Mental and behavioral health disorders