Related Experiment Videos
Abnormal and sphincter response in chronically constipated children
Insights
Children with chronic constipation often have weaker internal anal sphincters. This study found their sphincter resting tone and response to rectal distension were significantly lower, indicating a core functional issue.
Area of Science:
- Pediatric Gastroenterology
- Physiology
- Colorectal Surgery
Background:
- Chronic constipation is a common pediatric issue.
- Anal sphincter dysfunction is suspected in some cases.
- Understanding underlying mechanisms is crucial for effective treatment.
Purpose of the Study:
- To investigate anal sphincter function in children with chronic constipation.
- To compare sphincter function between constipated and healthy children.
- To assess changes in function after treatment.
Main Methods:
- Strain gauge manometry was used to measure anal sphincter function.
- Evaluated 116 constipated and 18 healthy children.
- Assessed resting tone, motor activity, and reflex responses to rectal distension.
Main Results:
- Constipated children showed significantly lower mean anal resting tone (P < 0.001).
- Internal anal sphincter motor activity and rectosphincteric reflex amplitude were reduced in constipated children (P < 0.001).
- These abnormalities persisted even in recovered patients.
Conclusions:
- The primary issue in chronically constipated children appears to be an abnormal internal anal sphincter.
- This sphincter is weaker and less responsive to rectal distension compared to nonconstipated children.
- Findings suggest a persistent functional deficit in the internal anal sphincter.
Abstract:
Using a strain gauge, we measured anal sphincter function in 116 chronically constipated and 18 healthy children. Eighteen constipated children were re-evaluated two months later (receiving laxative), and 15 were again studied seven to 12 months later. The anal resting tone varied along the length of the anal canal and was highest at 1 to 1.5 cm from the anal verge. This region was used to study the resting motor activity of the internal anal sphincter, the amplitude of the rectosphincteric reflex after 30 and 60 ml rectal distension, and the rectosphincteric reflex threshold. The mean and resting tone was significantly lower in constipated than in control children (P less than 0.001), but normalized in patients who recovered. Resting motor activity of the internal anal sphincter and the amplitude of RSR were significantly lower in constipated patients than were the corresponding values in control children (P less than 0.001), and remained lower during and after treatment, even in patients who recovered. The length of the anal canal and the RSR threshold were comparable in control and constipated children. Thus, the basic problem in chronically constipated children appears to be an abnormal internal anal sphincter, which is weaker and less responsive to rectal distension than in nonconstipated children.