Strong agreement between self-administered and interview-obtained bowel function score in patients with Hirschsprung disease and anorectal malformation

Pediatr Surg Int. 2025 Oct 6;41(1):312. doi: 10.1007/s00383-025-06207-3.

Abstract

Background: The Bowel Function Score (BFS) questionnaire is the most widely utilized tool for assessing bowel function in patients with Hirschsprung disease (HD) or anorectal malformation (ARM). However, the questionnaire has not undergone a formal validation process. This study aimed to compare self-administered responses with those obtained during clinical consultations to determine whether patients can reliably report their bowel function when completing the questionnaire independently.

Methods: "Patients with HD or ARM and/or with their parents, completed the BFS questionnaire prior to their outpatient clinic visit. During consultations, the questionnaires were reviewed, with any missing or unclear responses addressed and adjustments recorded. The agreement between self-administered and interview-obtained BFS scores was assessed using the intraclass correlation coefficient (ICC)."

Results: A total of 103 questionnaires with 721 answered questions were evaluated. The agreement between self-administered and interview-based BFS scores was found to be nearly perfect (ICC) 0.96. The question recording frequency of defecation, was the only item that did not demonstrate perfect agreement.

Conclusion: This study supports the use of the self-administered BFS questionnaire as a reliable tool for assessing bowel function in HD and ARM patients in both clinical practice and research.

Keywords: Anorectal malformation; Bfs; Bowel function score; Constipation; Fecal incontinence; Hirschsprung; Hirschsprung disease; Incontinence; Postoperative bowel function.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Anorectal Malformations* / physiopathology
  • Child
  • Child, Preschool
  • Defecation* / physiology
  • Female
  • Hirschsprung Disease* / physiopathology
  • Humans
  • Infant
  • Interviews as Topic*
  • Male
  • Reproducibility of Results
  • Self Report*
  • Surveys and Questionnaires