Investigation and management of long-standing chronic constipation in childhood.
The anorectal physiology of 106 children with long-standing chronic constipation, who had failed to response to a trial of medical treatment, was assessed. 10 (9%) were shown to have ultrashort-segment Hischsprung's disease, later confirmed on histology, The remainder showed evidence of hypertrophy of the internal sphicter on anorectal manometry and had a vigorous anal dilatation (to accept 4 fingers) under general anesthesia. After this, 38% were able to be weaned off all medication and most of the remainder improved. Further anal dilatation and internal sphincterotomy allowed a further 10 children to stop laxative, bringing the total to 48%.
D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000002:abnormalities* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003248:Constipation / Q000503:physiopathology* / Q000628:therapy; D004106:Dilatation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008531:Megacolon / Q000503:physiopathology*; D008722:Methods