eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
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SCImago Journal & Country Rank
4/2018
vol. 13
 
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abstract:
Original paper

High-resolution anorectal manometry in children with functional constipation: a single-centre experience before and after treatment

Mortada El-Shabrawi, Hind M. Hanafi, Manal M.A.H. Abdelgawad, Fetouh Hassanin, Aml A.A. Mahfouze, Ahmed F.M. Khalil, Saeed Elsayed Elsawey

Gastroenterology Rev 2018; 13 (4): 305–312
Online publish date: 2018/12/11
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Introduction
Constipation is a common disorder among children, and most of the cases are functional in aetiology. Few studies have reported the manometric data of normal and constipated children.

Aim
To evaluate the manometric parameters in children with functional constipation and to assess any possible changes in these parameters after treatment.

Material and methods
A prospective descriptive study was conducted at a single centre, enrolling 50 children diagnosed with functional constipation based on Rome IV criteria. Their age ranged from 6 to 14 years with a mean of 7.31 ±1.72 years. High-resolution manometry was performed on all children at the initial presentation and after six months of treatment.

Results
The studied children showed markedly abnormal rectal sensation parameters (increased first sensation, first urge, intense urge, and maximum tolerable volume) during rectal balloon distension. These parameters were even higher in children with stool incontinence (p = 0.005). Manometric data after 6 months of treatment showed that the resting and squeeze pressures were increased when compared to pre-treatment recordings; however, both were statistically insignificant (p = 0.474 and p = 0.155, respectively). Abnormalities in rectal sensations and the manometric parameters reached near normal values following treatment.

Conclusions
Anorectal manometry is sensitive in predicting improvement in patient condition even before complete clinical cure, and it has a prognostic role in the management of childhood constipation. More research is still needed before recommending anorectal manometry as a routine diagnostic or prognostic tool in paediatric constipation management.

keywords:

manometry, constipation, paediatric, Egypt

references:
Tabbers MM, DiLorenzo C, Berger MY, et al. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutrition 2014; 58: 258-74.
Rajindrajith S, Devanarayana NM. Constipation in children: novel insight into epidemiology, pathophysiology and management. J Neurogastroenterol Motility 2011; 17: 35-47.
Chang SH, Park KY, Kang SK, et al. Prevalence, clinical characteristics, and management of functional constipation at pediatric gastroenterology clinics. J Korean Med Sci 2013; 28: 1356-61.
Dehghani SM, Kulouee N, Honar N, et al. Clinical manifestations among children with chronic functional constipation. Middle East J Dig Dis 2015; 7: 31-5.
Hyams JS, Di Lorenzo C, Saps M, et al. Functional disorders: children and adolescents. Gastroenterology 2016; pii: S0016-5085(16)00181-5. doi: 10.1053/j.gastro.2016.02.015.
Biggs WS, Dery WH. Evaluation and treatment of constipation in infants and children. Am Family Phys 2006; 73: 469-77.
Loening-Baucke V. Polyethylene glycol without electrolytes for children with constipation and encopresis. J Pediatr Gastroenterol Nutr 2002; 34: 372-7.
Bekkali NL, van den Berg MM, Dijkgraaf MG, et al. Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG. Pediatrics 2009; 124: e1108-15.
Miller MK, Dowd MD, Friesen CA, Walsh-Kelly CM. A randomized trial of enema versus polyethylene glycol 3350 for fecal disimpaction in children presenting to an emergency department. Pediatr Emergency Care 2012; 28: 115-9.
Koppen IJN, Lammers LA, Benninga MA, Tabbers MM. Management of functional constipation in children: therapy in practice. Paediatr Drugs 2015; 17: 349-60.
Lee TH, Bharucha AE. How to perform and interpret a high-resolution anorectal manometry test. J Neurogastroenterol Motil 2016; 22: 46-59.
Hong J. Clinical applications of gastrointestinal manometry in children. Pediatr Gastroenterol Hepatol Nutrition 2014; 17: 23-30.
Banasiuk M, Banaszkiewicz A, Dziekiewicz M, et al. Values from three-dimensional high-resolution anorectal manometry analysis of children without lower gastrointestinal symptoms. Clin Gastroenterol Hepatol 2016; 14: 993-1000.e3.
Noviello C, Cobellis G, Papparella A, et al. Role of anorectal manometry in children with severe constipation. Colorectal Dis 2009; 11: 480-4.
Liu TT, Chen CL, Yi CH. Anorectal manometry in patients with chronic constipation: a single-center experience. Hepatogastroenterology 2008; 55: 426-9.
Loening-Baucke VA. Abnormal rectoanal function in children recovered from chronic constipation and encopresis. Gastroenterology 1984; 87: 1299-304.
Rajindrajith S, Devanarayana NM. Constipation in children: novel insight into epidemiology, pathophysiology and management. J Neurogastroenterol Motil 2011; 17: 35-47.
de Araujo Sant'Anna AM, Calcado AC. Constipation in school-aged children at public schools in Rio de Janeiro, Brazil. J Pediatr Gastroenterol Nutr 1999; 29: 190-3.
Morais MB, Vitolo MR, Aguirre AN, Fagundes-Neto U. Measurement of low dietary fiber intake as a risk factor for chronic constipation in children. J Pediatr Gastroenterol Nutr 1999; 29: 132-5.
Ip KS, Lee WT, Chan JS, Young BW. A community-based study of the prevalence of constipation in young children and the role of dietary fibre. Hong Kong Med J 2005; 11: 431-6.
Markland AD, Palsson O, Goode PS, et al. Association of low dietary intake of fiber and liquids with constipation: evidence from the National Health and Nutrition Examination Survey (NHANES). Am J Gastroenterol 2013; 108: 796-803.
Roma E, Adamidis D, Nikolara R, et al. Diet and chronic constipation in children: the role of fiber. J Pediatr Gastroenterol Nutr 1999; 28: 169-74.
Kocaay P, Egritas O, Dalgic B. Normal defecation pattern, frequency of constipation and factors related to constipation in Turkish children 0-6 years old. Turk J Gastroenterol 2011; 22: 369-75.
Felt B, Wise CG, Olson A, et al. Guideline for the management of pediatric idiopathic constipation and soiling. Multidisciplinary team from the University of Michigan Medical Center in Ann Arbor. Arch Pediatr Adolescent Med 1999; 153: 380-5.
Loening-Baucke V, Swidsinski A. Constipation is the most frequent cause of chronic abdominal pain in children. Open Pediatr Med J 2008; 2: 16-20.
Loening-Baucke V. Prevalence rates for constipation and faecal and urinary incontinence. Arch Dis Childhood 2007; 92: 486-9.
Fathy A, Megahed A, Barakat T, Abdalla AF. Anorectal functional abnormalities in Egyptian children with chronic functional constipation. Arab J Gastroenterol 2013; 14: 6-9.
Banasiuk M, Banaszkiewicz A, Albrecht P. PP-9 normal values of 3D high-resolution anorectal manometry in chidren. J Pediatr Gastroenterol Nutr 2015; 61: 523-4.
Kumar S, Ramadan S, Gupta V, et al. Manometric tests of anorectal function in 90 healthy children: a clinical study from Kuwait. J Pediatr Surg 2009; 44: 1786-90.
Nurko S, Garcia-Aranda JA, Guerrero VY, Worona LB. Treatment of intractable constipation in children: experience with cisapride. J Pediatr Gastroenterol Nutr 1996; 22: 38-44.
Turco R, Alessandrella A, Pozziello A, et al. High resolution anorectal manometry in children with functional constipation with or without fecal incontinence. Dig Liv Dis 2016; 48: e250.
Hou XY, Wang LY, Wang WL, et al. Clinical significance of detection of internal anal sphincter in children with functional constipation. Chin J Gastrointest Surg 2011; 14: 753-5.
Li ZH, Dong M, Wang ZF. Functional constipation in children: investigation and management of anorectal motility. World J Pediatr 2008; 4: 45-8.
Loening-Baucke V. Factors determining outcome in children with chronic constipation and faecal soiling. Gut 1989; 30: 999-1006.
Benninga MA, Wijers OB, van der Hoeven CW, et al. Manometry, profilometry, and endosonography: normal physiology and anatomy of the anal canal in healthy children. J Pediatr Gastroenterol Nutr 1994; 18: 68-77.
van den Berg MM, Voskuijl WP, Boeckxstaens GE, Benninga MA. Rectal compliance and rectal sensation in constipated adolescents, recovered adolescents and healthy volunteers. Gut 2008; 57: 599-603.
Martinac M, Ebling B, Dujšin M, et al. Clinical and anorectal motility features in chronically constipated children. Collegium Antropologicum 2011; 35: 505-12.
Borowitz SM, Sutphen J, Ling W, Cox DJ. Lack of correlation of anorectal manometry with symptoms of chronic childhood constipation and encopresis. Dis Colon Rectum 1996; 39: 400-5.
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