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Idiopathic disorders of fecal continence in children
Insights
Idiopathic bowel dysfunction in children often involves abnormal rectal pressures and delayed colonic transit. These functional issues are common in children experiencing fecal incontinence, impacting their bowel control.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
- Functional Bowel Disorders
Background:
- Idiopathic disorders of bowel function are common in children.
- Hirschsprung's disease is a known cause, but other functional abnormalities exist.
- Understanding these non-Hirschsprung's conditions is crucial for effective management.
Purpose of the Study:
- To investigate functional abnormalities in children with idiopathic bowel disorders.
- To assess anorectal motility and colorectal transit.
- To identify the prevalence of constipation and functional deficits.
Main Methods:
- Investigated 176 patients aged 2-15 years with idiopathic bowel dysfunction.
- Assessed anorectal motility and colorectal transit using radiopaque markers.
- Analyzed resting pressure in the rectal ampulla and anal canal.
Main Results:
- 70 patients (40%) presented with constipation within the first month of life.
- Elevated and unstable resting pressure was observed in the rectal ampulla and upper anal canal.
- Colorectal transit was significantly retarded in 61% of patients, indicating delayed bowel movement.
Conclusions:
- The majority of children with idiopathic bowel disorders exhibit functional abnormalities.
- Anorectal motility and colorectal transit studies are vital for diagnosing these conditions.
- Early identification and intervention can improve outcomes for children with fecal incontinence.
Abstract:
A group of 176 patients aged 2 to 15 years was investigated for idiopathic disorders of bowel function other than Hirschsprung's disease. Anorectal motility, as well as colorectal transit of radiopaque markers, were investigated. Before the end of the first month of life, 70 of the patients were constipated. Resting pressure was more unstable (P less than 0.001) and higher than normal in the rectal ampulla and upper anal canal (P less than 0.01). Retardation of markers occurred in the proximal and/or distal large bowel of 61% of the patients. The existence of functional abnormalities was demonstrated in the majority of children with idiopathic disorders of fecal continence.