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Usefulness of ultrasound in diagnosing constipation in children: a narrative review
Katarzyna Bąk-Drabik1, Martyna Laskowska2, Katarzyna Głuszko2
1Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland.
Insights
Ultrasound effectively diagnoses chronic constipation in children by assessing fecal retention and colonic filling. This non-invasive method aids in distinguishing functional from organic causes, improving pediatric constipation management.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Diagnostic Ultrasound
Background:
- Chronic constipation is a prevalent issue in pediatric care, impacting children and families.
- Functional constipation is common, but identifying organic causes is crucial.
- Current diagnostic methods may be invasive or less objective.
Purpose of the Study:
- To evaluate the utility of transabdominal intestinal ultrasound in diagnosing pediatric constipation.
- To assess ultrasound's role in differentiating functional from organic causes.
- To explore ultrasound's potential in managing constipation.
Main Methods:
- Utilized transabdominal intestinal ultrasound for objective assessment of fecal retention.
- Measured rectal diameter, rectal wall thickness, and degree of colonic filling.
- Considered perianal ultrasonography for detailed anal structure evaluation.
Main Results:
- Ultrasound provides objective measurement of fecal retention and colonic filling.
- The technique is non-invasive, cost-effective, and repeatable.
- Ultrasound can aid in assessing stool consistency and colonic transit.
Conclusions:
- Transabdominal intestinal ultrasound is a valuable, non-invasive tool for diagnosing pediatric constipation.
- Ultrasound assists in excluding organic causes and managing functional constipation.
- Further standardization of ultrasound methodology and criteria is needed for optimal use.
Abstract:
Chronic constipation in children is a significant problem not only for the child but also for the family and caregivers in institutional settings. Constipation is a common clinical symptom, accounting for nearly one-third of consultations in pediatric gastroenterology clinics. In the vast majority of cases, the cause is functional constipation, whose pathogenesis is complex but usually benign. The greatest challenge lies in identifying organic causes within this patient group, for which ultrasound is particularly well suited as a non-invasive tool for exclusion. Transabdominal intestinal ultrasound is an ideal diagnostic tool due to its non-invasive, cost-effective, and repeatable nature, and its ability to be performed during routine outpatient visits. It enables objective assessment of fecal retention by measuring rectal diameter (RD), rectal wall thickness, and degree of colonic filling. In addition, ultrasound may be useful for assessing stool consistency and colonic transit. Perianal ultrasonography is a complementary method to transabdominal intestinal ultrasound, enabling a more detailed evaluation of anal canal structures. Ultrasound may therefore represent a valuable adjunct in the diagnosis and management of pediatric constipation, although further standardization of methodology and diagnostic criteria is required.
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