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Clinical significance of anismus in encopresis

A G Catto-Smith1, T M Nolan, C M Coffey

  • 1Department of Gastroenterology, Royal Children's Hospital, Parkville, Victoria, Australia. cattosmt@cryptic.rch.unimelb.edu.au

Journal of Gastroenterology and Hepatology
|October 30, 1998
PubMed

Insights

Electromyographic anismus, a paradoxical contraction of anal sphincters, is linked to significant fecal retention in children with encopresis. This finding supports its clinical relevance in childhood anorectal dysfunction.

Area of Science:

  • Pediatric Gastroenterology
  • Anorectal Physiology

Background:

  • Treatments for anismus in children with encopresis show limited success, questioning its clinical significance.
  • Anorectal dysfunction is a complex issue in pediatric encopresis management.

Purpose of the Study:

  • To investigate the association between electromyographic anismus and fecal retention in children with treatment-resistant encopresis.
  • To clarify the clinical relevance of anismus as a cause of obstructed defecation in pediatric patients.

Main Methods:

  • Sixty-eight children with soiling underwent clinical examination, abdominal radiography, and anorectal manometry.
  • Electromyographic anismus was assessed, and its correlation with radiographic fecal retention and defecation capacity was analyzed.

Main Results:

  • Electromyographic anismus was present in 47% of patients (n=32).
  • Patients with electromyographic anismus demonstrated significantly increased rectal fecal retention.
  • These patients were less likely to successfully defecate water-filled balloons.

Conclusions:

  • Electromyographic anismus is significantly associated with increased fecal retention in children with encopresis.
  • The findings support the clinical relevance of diagnosing and treating anismus in cases of obstructed defecation and childhood encopresis.

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