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Evaluation of anorectal functions of children with anorectal malformations using fecoflowmetry
Hiroyuki Kayaba1, Tatsuzo Hebiguchi, Hiroaki Yoshino
1Central Clinical Laboratory and Department of Pediatric Surgery, Akita University Hospital, Akita, Japan.
Insights
Fecoflowmetry and saline enema tests offer objective insights into bowel function for children with anorectal anomalies, aiding in assessing fecal continence and rectal motility.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Anorectal Physiology
Background:
- Anorectal anomalies require objective methods to evaluate bowel function.
- Assessing fecal continence and rectal motility is crucial for patient management.
Purpose of the Study:
- To apply fecoflowmetry and saline enema tests to evaluate fecal dynamics and anorectal motility in children with anorectal anomalies.
- To correlate clinical bowel function scores with objective fecodynamic parameters.
Main Methods:
- Saline enema test and fecoflowmetry were performed on 16 patients with repaired anorectal malformations and 5 controls.
- Clinical bowel function scores were compared with fecodynamic parameters.
Main Results:
- Patients with synchronized rectal contractions and anal canal relaxation during saline infusion had higher clinical scores.
- Lower maximum flow, average flow, and tolerable saline volume were observed in patients with poor clinical scores compared to controls.
- Rectal contractions were absent in two patients with severe chronic constipation.
Conclusions:
- Fecodynamic studies, including fecoflowmetry and saline enema tests, provide valuable clinical indicators for assessing bowel function in patients with anorectal anomalies.
- These methods can help differentiate functional outcomes and guide treatment strategies.
Background/Purpose:
A simple and objective method evaluating the bowel functions of patients with anorectal anomalies is necessary. The authors applied fecoflowmetry and saline enama test for patients with anorectal anomalies to evaluate the fecodynamics and anorectal motilities in these children.
Methods:
The bowel functions of 16 patients who underwent repair for anorectal malformations and 5 normal controls were evaluated by saline enema test and fecoflowmetry. The correlations between the clinical scores for the bowel functions and the parameters in fecodynamic studies were investigated.
Results:
Seven of 16 patients exhibited periodical contractions of the rectum synchronized with relaxations of the anal canal during saline infusion as did the controls and had significantly higher clinical scores than the other patients. Two patients with severe chronic constipation lacked rectal contractions. Among the fecoflowmetric parameters, the maximum flow, average flow, and tolerable volume of saline infused into the rectum were significantly lower in the patients with low clinical scores than those of the controls. The maximal squeeze pressure and resting anal pressure were not significantly different between the patients and controls.
Conclusion:
Fecodynamic studies, such as fecoflowmetry and saline enema test, help in obtaining clinical indicators for the bowel functions of patients with anorectal anomalies.