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

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.