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The analysis of clinical course of chronic constipation in children and adolescents --- Analiza przebiegu klinicznego przewleklych zaparc u dzieci i mlodziezy

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Author(s): Marek Kurnatowski | Ewa Toporowska-Kowalska | Beata Gebora-Kowalska | Krystyna Wssowska-Krolikowska

Journal: Przegląd Pediatryczny
ISSN 0137-723X

Volume: 37;
Issue: 2;
Start page: 227;
Date: 2007;
Original page

ABSTRACT
Background: Chronic constipation is defined as passing of hard stool less than twice a week, for more than four weeks. In 95% of cases, constipation is due to functional disorders. The aim of the study was to analyse clinical course and causes of chronic constipation in children and adolescents and estimate the role of anorectal manometry in the diagnostic scheme. Material and methods: We examined 80 children and adolescents with chronic constipation. The diagnostic scheme included laboratory tests, radiological examination and anorectal manometry. Results: Children mainly complained of rectal tenesmus (85.0%), defecation was observed less than twice a week (82.5%). Pa-tients passed hard stools (78.8%), complained of pain during defecation (75.0%) and abdominal pain (71.3%). Laboratory tests were within normal limits. Hinton test indicated outlet obstruction in 7 patients and colonic inertia in 6 of them. Radiography was done in 60 patients: in 38 children colonic elongation and in 29 patients spastic colitis was diagnosed. Among all the children recto-anal inhibitory reflex (RAIR) was recognised. We used biofeedback as a therapy in 16 patients with a good effect in 10 of them. Conclusions: 1. In all children and adolescents functional constipation according to ROME III was diagnosed. 2. Anorectal manometry is a useful method to diagnose the causes of chronic constipation in children and adolescents and can reduce the use of invasive diagnostic methods.
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