Assessment of hindgut function in premature newborns

Anorectal manometry was performed on 32 small for dates and or preterm infants, using a micro-tip pressure transducer. A normal rectoanal reflex was observed in otherwise normal infants on the first day of life. During the neonatal period, hindgut function in these infants was studied longitudinally using the minimum excitation energy (MER) to elicit a rectoanal reflex. Data suggest that hindgut dysfunction (indicated by a significant increase in MER) develops prior to the onset of abdominal distension or necrotizing enterocolitis (NEC), rather than being present from birth. Consequently, this abnormality of function probably does not initiate the process that leads to NEC. This increase in MER may be a warning that the infant is about to develop abdominal distension or NEC.