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Manometric evaluation of children with chronic constipation using a suction-stimulating electrode
M Kubota1, A Nagasaki, K Sumitomo
1Medical Center for Sick Children Fukuoka City, Section of Surgery, Japan.
Insights
This study evaluated chronic constipation in children using manometry. Electrical stimulation of the rectal mucosa successfully induced the rectoanal reflex in most patients, suggesting potential nervous system involvement.
Area of Science:
- Pediatric Gastroenterology
- Neurogastroenterology
- Anorectal Physiology
Background:
- Chronic constipation is a common pediatric issue.
- Understanding anorectal function is crucial for diagnosis.
- Manometric studies help assess rectal and anal function.
Purpose of the Study:
- To evaluate the utility of a suction-stimulating electrode in pediatric anorectal manometry.
- To investigate the rectoanal reflex in children with chronic constipation.
- To identify potential neurophysiological disturbances contributing to constipation.
Main Methods:
- Manometric evaluation of 13 children (aged 1 month to 9 years) with chronic constipation.
- Induction of the rectoanal reflex via balloon distension of the rectum.
- Electrical stimulation of rectal mucosa using a suction-stimulating electrode to measure reflex threshold voltage and latency.
Main Results:
- The rectoanal reflex was elicited in all patients by balloon distension.
- Electrical stimulation successfully triggered the reflex in 9 out of 13 patients.
- The mean threshold voltage was 22.2 ± 3.6 V and mean latency was 2.04 ± 0.38 s for electrical stimulation.
Conclusions:
- A suction-stimulating electrode is a valuable adjunct in pediatric anorectal manometry.
- Disruptions in the rectal nervous system may be a contributing factor to chronic constipation in children.
- This technique aids in the etiological investigation of pediatric constipation.
Abstract:
Thirteen children with chronic constipation (8 males and 5 females, aged 1 month to 9 years) were evaluated manometrically. A suction-stimulating electrode was used to induce the rectoanal reflex electrically so as to examine the threshold voltage and latency of this reflex. The rectoanal reflex was induced in all patients by balloon dilatation of the rectum. However, electrical stimulation of the rectal mucosa triggered a reflex in only nine of them and the threshold voltage and latency was 22.2 +/- 3.6 volts (mean +/- SD, n = 9) and 2.04 +/- 0.38 seconds (n = 9), respectively. Hence, it is suggested that a suction-stimulating electrode is a useful supportive tool in manometric anorectal studies, and that disturbances in the rectal nervous system might be one of the causative factors in chronic constipation in childhood.