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New insight into rectal function in pediatric defecation disorders: disturbed rectal compliance is an essential

Wieger P Voskuijl1, Rijk van Ginkel, Marc A Benninga

  • 1Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam, The Netherlands. w.p.voskuijl@amc.nl

The Journal of Pediatrics
|January 21, 2006
PubMed

Insights

Pediatric constipation (PC) is characterized by increased rectal compliance, requiring larger volumes for defecation urge. Nonretentive fecal soiling (FNRFS) shows normal rectal function in children.

Area of Science:

  • Pediatric gastroenterology
  • Colorectal physiology

Background:

  • Pediatric constipation (PC) and nonretentive fecal soiling (FNRFS) are common functional gastrointestinal disorders.
  • Understanding rectal sensory and compliance abnormalities is crucial for effective management.

Purpose of the Study:

  • To assess rectal sensitivity and compliance in children with PC and FNRFS using barostat technology.
  • To differentiate rectal function between PC, FNRFS, and healthy controls.

Main Methods:

  • Utilized a barostat for pressure-controlled rectal distention in 69 PC patients, 19 FNRFS patients, and 22 healthy volunteers.
  • Measured thresholds for first sensation, urge to defecate, pain, and rectal compliance.

Main Results:

  • Rectal sensitivity thresholds were similar across all groups.
  • Increased rectal compliance was observed in 58% of PC patients compared to healthy volunteers (P < .0001).
  • Rectal compliance was normal in FNRFS patients; however, PC patients with abnormal rectal function needed larger volumes for defecation urge.

Conclusions:

  • Elevated rectal compliance is a key finding in pediatric constipation.
  • Higher rectal compliance in PC necessitates larger stool volumes to trigger the urge to defecate.
  • Children with FNRFS exhibit normal rectal function.
Abstract

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