Fat Grafting Shows Promise for Children's Bowel Control

Study tests Lipogems® procedure in six children with fecal incontinence

Researchers in Italy investigated whether injecting a child's own processed fat tissue could help improve bowel control. The study included six boys (average age about eleven years) who experienced fecal incontinence—the inability to control bowel movements. Most of these children had been born with anorectal malformations, which are birth defects affecting the opening where stool exits the body. Standard treatments like diet changes and medications had not fully helped these patients.

Procedure uses child's own fat tissue for treatment

The treatment involved harvesting fat from each child's abdomen during a brief procedure under general anesthesia. The fat was then processed using the Lipogems® system, which gently breaks down fat into smaller pieces while preserving the natural healing cells within it. These cells include pericytes (helper cells that support blood vessel healing) and mesenchymal stem cells (regenerative cells that can help repair tissues). The processed fat was then injected into the anal sphincter area using ultrasound guidance to ensure precise placement.

Most children showed meaningful improvement in symptoms

Five of the six children experienced stable improvement in bowel function. Before treatment, all children had daily soiling that caused social problems (grade three on the Krickenbeck scale). After treatment, seventy-five percent improved to only occasional soiling once or twice weekly (grade one). The researchers performed twelve total procedures across the six patients, suggesting some children benefited from repeat treatments. Ultrasound imaging during follow-up showed the sphincter muscle had become thicker, which may explain the improved control.

No serious complications occurred during or after treatment

The procedure proved safe for all children involved. No major complications developed after any of the twelve treatments. Because the fat comes from the child's own body, there is no risk of rejection or immune reaction. The minimally invasive nature of fat harvesting from the abdomen causes only minor discomfort at the donor site.

Family quality of life improved after children's treatment

Beyond measuring physical symptoms, the researchers asked parents about their family's quality of life before and after treatment. Parents completed questionnaires covering three areas: lifestyle limitations, feelings of depression, and embarrassment. Before treatment, many parents reported avoiding social activities, feeling different from other families, and worrying about their child's leaks causing embarrassment at school. After their children received treatment, parents reported improvements across these areas.

Promising results warrant further research in larger groups

This small case series suggests that fat grafting using Lipogems® technology may offer a safe, effective option for children with fecal incontinence who have not responded to standard treatments. The injected fat appears to work in two ways: as a physical bulking agent that helps the sphincter close more completely, and through its regenerative properties that may improve tissue function over time. However, this study included only six patients without a comparison group. Larger studies with longer follow-up will help confirm these encouraging early findings and determine which children are most likely to benefit.

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Source: Pinto et al., Journal of Clinical Medicine, 2023.