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Manometric evaluation of the anorectal region in children and youth affected by functional constipation with normal and slow colonic transit time

Author(s): Radosława Jakóbiec | Mieczysława Czerwionka-Szaflarska

Journal: Polish Gastroenterology
ISSN 1232-9886

Volume: 15;
Issue: 5;
Start page: 313;
Date: 2008;
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Keywords: anorectal manometry | colonic transit time | functional constipation

Introduction: Most cases of constipation among children are functional problems. Anorectal manometry and colonic transit time (CTT) are simple and non-invasive methods to distinguish a group of patients, requiring more profound diagnosis and to find an effective mode of treatment. Aim of study was an analysis of the selected parameters of the anorectal manometry in children and youth affected by functional constipation with normal and slow CTT. Material and methods: In 261 children, fulfilling Rome II diagnostic criteria for functional constipation, the CTT measurement and anorectal manometry were performed. Results: The children group between 4 and 7 years of age had the lowest values of pressure in the upper anal canal. The group of patients with very delayed CTT had the lowest mean pressure values in the lower anal canal, higher mean values of rectal sensation thresholds and more frequent presence of megarectum measured in manometry. An abnormal push/strain attempt in manometric examination occurred in 33% of examined subjects. Megarectum presence in manometry studies was diagnosed in 53% of the patients. The probability of the occurrence of megarectum increased along with the prolongation of CTT. Conclusions: In the analysis of the patients with functional constipation it is reasonable to distinguish the group with very delayed CTT for longer observation, extended diagnosis, or another mode of treatment. Manometric evaluation of the rectal sensation thresholds and the mean anal canal pressure in patients with functional constipation correspond to total colonic transit time (tCTT) and complement the diagnostic procedures determining the scale of functional disorders of anorectum.
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