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Electroacupuncture Combined with Chinese Medicine Ironing Therapy for Functional Constipation
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Functional constipation or redundancy of the colon?

Carmine Noviello1, Stefano Nobile2, Mercedes Romano3

  • 1Pediatric Surgery Unit, Salesi Children Hospital, Via Corridoni, 11, 60128, Ancona, Italy. carmine.noviello@libero.it.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|May 15, 2020
PubMed
Summary

Children with functional refractory constipation may have anatomical colon changes, specifically a rectosigmoid length to L2 ratio over 15, aiding targeted treatment.

Keywords:
Anorectal manometryContrast enemaFunctional constipationRedundancy of the colon

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Area of Science:

  • Pediatric Gastroenterology
  • Colorectal Surgery
  • Medical Imaging

Background:

  • Functional refractory constipation is common in children.
  • Anatomical colon alterations are hypothesized in functional refractory constipation.

Purpose of the Study:

  • To investigate anatomical colon alterations in children with functional refractory constipation.
  • To identify potential diagnostic markers for targeted treatment.

Main Methods:

  • Clinical examination, contrast enema (CE), anorectal manometry (ARM), and rectal suction biopsies (RSB) were performed.
  • Colon size and rectosigmoid length to L2 vertebral width ratio were measured using radiograms.
  • Measurements were compared to age-matched controls without constipation.

Main Results:

  • Out of 69 patients, 57 (82.61%) were diagnosed with functional constipation.
  • No statistically significant differences were found except for rectosigmoid length.
  • The rectosigmoid length/L2 ratio was significantly higher in constipated children compared to controls.

Conclusions:

  • Anatomical anomalies, particularly an elevated rectosigmoid length/L2 ratio (>15), are associated with functional constipation in children.
  • Identifying these anomalies is crucial for guiding specific treatment strategies.
  • This finding supports a more detailed anatomical evaluation in refractory pediatric constipation.