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Comorbidities associated with constipation in children referred for colon manometry may mask functional diagnoses

J T Gertken1, Jose Cocjin, Nonko Pehlivanov

  • 1Department of Pediatrics, University of Kansas, Kansas City, Kansas 66160, USA.

Journal of Pediatric Gastroenterology and Nutrition
|September 1, 2005
PubMed

Insights

Colon manometry is often normal in children with constipation, frequently indicating functional fecal retention (FFR). Comorbid conditions can complicate FFR diagnosis in pediatric patients.

Area of Science:

  • Pediatric Gastroenterology
  • Colorectal Surgery
  • Pediatric Surgery

Background:

  • Colon manometry aids in differentiating functional fecal retention (FFR) from colon neuromuscular diseases in children with refractory constipation.
  • Identifying specific clinical features prompting colon manometry referral is crucial for accurate diagnosis.

Purpose of the Study:

  • To determine the clinical characteristics that lead to referral for colon manometry in pediatric patients diagnosed with functional constipation.

Main Methods:

  • A retrospective review of medical records for 173 constipated children (aged 1-17 years) who underwent colon manometry.
  • Analysis of manometry results, diagnostic outcomes (FFR, irritable bowel syndrome, functional constipation, neuromuscular disease), and presence of comorbid conditions.

Main Results:

  • Colon manometry was normal in 70% of children, with functional fecal retention (FFR) being the most common diagnosis (96/121).
  • Comorbid conditions were significantly more prevalent in children with FFR (76%) compared to those with colon neuromuscular disease (23%).
  • Fecal incontinence was a more frequent symptom in children over 4 years with FFR (71%) than in those with other functional disorders (10%) or neuromuscular disease (26%).

Conclusions:

  • Two-thirds of children referred for colon manometry received a functional diagnosis, primarily FFR.
  • Comorbid conditions frequently obscured the diagnosis of functional constipation in a significant proportion of children undergoing colon manometry.
Abstract

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