Dyssynergic Defecation in Chronically Constipated Children in Korea

Area of Science:

• Pediatric Gastroenterology
• Colorectal Surgery
• Functional Bowel Disorders

Background:

• Dyssynergic defecation (DSD) is a significant cause of chronic constipation in pediatric populations.
• Understanding the clinical characteristics and treatment outcomes of DSD is crucial for effective management.

Purpose of the Study:

• To analyze the clinical features of DSD in children.
• To evaluate diagnostic test results, including colon transit time (CTT).
• To assess the effectiveness of biofeedback (BF) therapy and medical treatments for DSD.

Main Methods:

• Retrospective analysis of clinical data from children diagnosed with DSD via fluoroscopic defecography.
• Inclusion of colon transit time (CTT) test results and biofeedback (BF) therapy outcomes.
• Review of medical records for treatment responses to polyethylene glycol 4000 and BF.

Main Results:

• Nineteen children diagnosed with DSD were studied, with a median age of 9 years and a median constipation duration of 7 years.
• Colon transit time (CTT) tests revealed outlet obstruction in 55.6% and slow transit in 27.8% of patients.
• Biofeedback (BF) therapy combined with medication showed good response rates (75% in BF group, 6/8 in combined therapy group).

Conclusions:

• Dyssynergic defecation (DSD) should be considered in pediatric chronic constipation, particularly with abnormal CTT findings.
• Combined biofeedback (BF) and medical therapy demonstrate efficacy in managing DSD in children.
• BF therapy is effective even in pediatric patients with limited cooperation due to age.