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Is the afferent pathway from the rectum impaired in children with chronic constipation and encopresis?

V Loening-Baucke1, T Yamada

  • 1Department of Pediatrics, University of Iowa, Iowa City, USA.

Gastroenterology
|August 1, 1995
PubMed

Insights

Children with chronic constipation and encopresis show impaired rectal sensation due to prolonged latencies in their visceral afferent pathways. This suggests a defect in the rectal afferent pathway affecting sensation.

Area of Science:

  • Pediatric Gastroenterology
  • Neurophysiology
  • Colorectal Function

Background:

  • Rectal sensation impairment is common in pediatric chronic constipation and encopresis.
  • This sensory deficit may stem from defects in visceral afferent pathways.
  • Persistent impairment is linked to poor treatment outcomes.

Purpose of the Study:

  • To investigate potential impairments in the rectal afferent pathway.
  • To assess visceral afferent pathway function in children with constipation and encopresis.

Main Methods:

  • Compared evoked potentials (EPs) in 15 healthy children and 15 with constipation/encopresis.
  • EPs were elicited by rectal balloon distention (10, 20, 30 mL) and recorded from Cz' to Fz.
  • Averaged 100 rectal distentions per subject.

Main Results:

  • Two EP types observed: early-onset (smaller volumes) and late-onset (larger volumes).
  • Prolonged N1 and P2 latencies (early-onset) and N1, P1, NII latencies (late-onset) in constipated children.
  • Latency differences were significant compared to controls.

Conclusions:

  • Prolonged EP latencies indicate a compromised rectal afferent pathway.
  • This finding supports a defect in visceral afferent signaling in pediatric constipation and encopresis.
  • Suggests a neurophysiological basis for sensory dysfunction in these conditions.
Abstract

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