Traditionally, the long-term results of low malformations are considered to be good in the great majority of patients (Table 28.1) [4,17,31,32,55]. The poor results have been considered to be related to neurological damage and mental retardation  or insufficient long-term care of the patients [3,32]. Recently, more critical and comprehensive analyses have demonstrated clearly a significant number of patients with functional aberrations, especially chronic constipation (Table 28.1). In the series of Yeung and Kiely , 15 of 32 children with a follow-up between 1 and 7 years had normal bowel function. Of the remaining 17 patients, all had constipation and 9 occasional or frequent soiling requiring treatment. Rintala et al.  used a scoring system to compare the bowel function of 40 children with low anomalies with that of healthy children. Only 52% of their patients had scores within the range of healthy children; constipation was found in 42% and soiling in 10% of the patients. Ong and Beasley  reported a follow-up of 70 patients with low ARM; of the 35 children under the age of 15, 9 were clean, 14 had occasional smearing, and 12 soiling. Laboure et al.  reported 27 male patients with 3-20 years follow-up; 48% of the patients had long-term problems related to constipation or soiling. Javid et al.  found, in their series of 44 girls with low imperforate anus, that 47% experienced at least occasional fecal incontinence. The median follow-up time in this series was 11 years.
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Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.