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Anorectal manometry in children with chronic functional constipation
Rosa Helena Monteiro Bigélli1, Maria Inez Machado Fernandes, Yvone Avalloni de Moraes Villela de Andrade Vicente
1Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
Insights
Standard treatment for pediatric chronic functional constipation reduced anal basal pressure. However, the relaxation reflex did not fully normalize, indicating persistent underlying issues in constipated children.
Area of Science:
- Pediatric Gastroenterology
- Physiology
- Clinical Medicine
Background:
- Anorectal manometry is crucial for diagnosing pediatric chronic functional constipation.
- Key manometric findings include anal sphincter dysfunction and altered rectal functions.
Purpose of the Study:
- To assess changes in anal basal pressure and the rectoanal inhibitory reflex post-treatment.
- To deepen understanding of the pathophysiology in pediatric functional constipation.
Main Methods:
- Anorectal manometry was conducted on 20 children (4-12 years) with functional constipation before and after standard treatment.
- Outcomes were evaluated based on treatment success.
Main Results:
- A significant reduction in anal basal pressure was observed after treatment.
- No significant differences were found in relaxation reflex parameters (amplitude, duration, latency, etc.) pre- and post-treatment.
Conclusions:
- Treatment led to decreased anal basal pressure in recovering children.
- Standard treatment did not fully restore the rectoanal inhibitory reflex to normal levels in constipated children.
Background:
The anorectal manometry is a very utilized and well recognized examination in children with chronic functional constipation. The major manometric findings in these children are: anal hypotonia, anal hypertonia, paradoxal contraction of the external anal sphincter, decreased ability of internal anal sphincter to relax during rectal distension and alterations in rectal contractility, sensibility and compliance.
Aims:
To evaluate the anal basal pressure and the relaxation reflex before and after standard treatment for a better understanding of the physiopathologic mechanisms involved in pediatric chronic functional constipation.
Methods:
Anorectal manometry was performed before treatment on 20 children with chronic functional constipation aged 4 to 12 years and the results were compared to those obtained after standard treatment, with a good outcome.
Results:
There was a reduction in anal basal pressure after treatment, but no differences were detected between the anorectal manometries performed before and after treatment in terms of amplitude and duration of relaxation, residual pressure, latency time, or descent and ascent angle.
Conclusions:
We conclude that the anal basal pressure decreased in children recovering from chronic functional constipation, but the standard treatment did not provide all the conditions necessary for the relaxation reflex of constipated children to return to the values described in normal children.
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