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Changes in the parameters of the rectoanal inhibitory reflex in children with functional constipation and large

Daniela Pop1, Simona Tătar2, Otilia Fufezan3

  • 1Mother and Child Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Medicine and Pharmacy Reports
|February 25, 2021
PubMed

Insights

In children with functional constipation, rectal diameter was larger, but rectoanal inhibitory reflex (RAIR) characteristics did not correlate with rectal size. This suggests constipation impacts rectal dimensions independently of reflex function.

Area of Science:

  • Pediatric Gastroenterology
  • Physiology
  • Diagnostic Imaging

Background:

  • Functional constipation is common in children, often assessed using abdominal ultrasound and anorectal manometry.
  • The rectoanal inhibitory reflex (RAIR) is a key physiological response evaluated in these assessments.
  • Understanding the relationship between rectal dimensions and RAIR is crucial for diagnosing and managing pediatric constipation.

Purpose of the Study:

  • To assess changes in RAIR characteristics in children with functional constipation.
  • To correlate RAIR parameters with rectal dimensions measured by abdominal ultrasound.
  • To compare rectal size in constipated versus non-constipated children.

Main Methods:

  • Retrospective review of 51 children with functional constipation and 27 controls.
  • Abdominal ultrasound to measure rectal ampulla transverse diameter.
  • Anorectal manometry to assess RAIR parameters (air volume, latency, relaxation time, percentage).

Main Results:

  • No significant correlation was found between rectal transverse diameter and the minimal air volume required to induce RAIR (r=-0.01, p=0.94).
  • Children with functional constipation had a significantly larger mean rectal transverse diameter (39±14 mm) compared to controls (26±6 mm, p<0.05).
  • The average duration of constipation symptoms was 2.8 years.

Conclusions:

  • Rectal transverse diameter in children with functional constipation is increased compared to healthy children.
  • No correlation exists between rectal diameter and the air volume needed to elicit RAIR in this population.
  • These findings suggest rectal distension in functional constipation may occur independently of RAIR characteristics.
Abstract

Keywords:
abdominal ultrasoundchildrenfunctional constipationrectoanal inhibitory reflex

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