Anorectal manometry in children with retentive fecal incontinence: What parameters should we evaluate?

Area of Science:

• Pediatric Gastroenterology
• Colorectal Physiology

Background:

• Functional constipation is common in children.
• Altered rectal compliance and defecatory sensation are key features.
• Anorectal manometry (ARM) can evaluate these alterations.

Purpose of the Study:

• To assess the utility of ARM parameters in children with retentive fecal incontinence (RFI).
• To differentiate children with RFI from those with functional constipation alone.

Main Methods:

• Anorectal manometry (ARM) was performed on children aged 4-17 years.
• Participants included children with functional constipation and those with functional constipation and RFI.
• Key parameters evaluated included rectal compliance and urge-to-defecate sensation.

Main Results:

• 35 children were evaluated (21 functional constipation, 14 functional constipation with RFI).
• Children with RFI tolerated higher air volumes for urge and pain tolerance.
• A cutoff of 135ml air volume distinguished children with RFI.

Conclusions:

• Maximum pain tolerance is a valuable ARM parameter for RFI evaluation.
• ARM can effectively identify RFI in children with functional constipation.