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Anorectal manometry in children with defecation disorders BSPGHAN Motility Working Group consensus statement

Eleni Athanasakos1, Stewart Cleeve1, Nikhil Thapar2,3

  • 1Paediatric Surgery, Royal London Hospital, London, UK.

Neurogastroenterology and Motility
|January 29, 2020
PubMed

Insights

Anorectal manometry (ARM) and high-resolution anorectal manometry (HRAM) help assess pediatric defecatory disorders like constipation and incontinence. New guidance aims to standardize its use in children for better diagnosis and care.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Diagnostics
  • Functional Bowel Disorders

Background:

  • Defecatory disorders, including chronic constipation (CC) and fecal incontinence (FI), are prevalent in children, impacting quality of life and healthcare resources.
  • Anorectal manometry (ARM) and high-resolution anorectal manometry (HRAM) are advanced diagnostic tools for evaluating anorectal function, crucial for understanding defecation.
  • While ARM is standard for adults, its pediatric application lacks standardized guidelines, leading to practice variations.

Purpose of the Study:

  • To provide evidence-based guidance on the appropriate use of ARM/HRAM in pediatric patients.
  • To establish standardized protocols and interpretative criteria for ARM/HRAM in children with CC and FI.
  • To promote consistent and accurate diagnosis of defecatory disorders in pediatric populations.

Main Methods:

  • Review of existing literature and expert consensus development by the BSPGHAN-Motility Working Group.
  • Formulation of recommendations for indications, procedural protocols, and normal values for pediatric ARM/HRAM.
  • Guidance on the interpretation of ARM/HRAM findings in the context of pediatric constipation and fecal incontinence.

Main Results:

  • Identification of key indications for ARM/HRAM in children with chronic constipation and fecal incontinence.
  • Proposal of standardized protocols for performing ARM/HRAM in pediatric patients.
  • Establishment of reference ranges and interpretation guidelines tailored for the pediatric population.

Conclusions:

  • Standardized ARM/HRAM protocols are essential for accurate diagnosis of pediatric defecatory disorders.
  • This guidance aims to reduce practice variability and improve the diagnostic yield of ARM/HRAM in children.
  • Consistent application of these guidelines will enhance the management of pediatric chronic constipation and fecal incontinence.

Keywords:
anal sphincteranorectal functionfaecal incontinencehigh -resolution anorectal manometrypaediatric chronic constipation

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