title: Fecoflowmetric evaluation of anorectal function and ability to defecate in children with idiopathic chronic constipation.
abstract: Idiopathic chronic constipation (ICC) is one of the most common clinical conditions in children. The pathophysiology is multifactorial and differs from case to case. To investigate the relationship between anorectal motility (ARM) and clinical course in children with ICC, anorectal function was evaluated using fecoflowmetry in nine children aged 2-14 years (mean 6.1). Three were boys and six were girls. Pressure fluctuations in the rectum and anal canal were simultaneously recorded during saline (250-500 ml) infusion into the rectum. The dynamics of defecation were evaluated using recordings of the saline evacuation curve from the rectum in each patient. Seven patients showed periodic contractions of the rectum accompanied (five) or unaccompanied (two) by relaxations of the anal canal during saline infusion. These patients achieved comfortable spontaneous defecation during follow-up periods ranging from 5 to 20 months. The other two exhibited no rectal contractions in spite of relaxations of the anal canal, and did not respond well to long-term medical management. In eight patients segmental fecoflowmetric curves showed a significantly lower flow rate and longer evacuation time than those of controls. Fecoflowmetry is a simple and non-invasive technique for evaluation of the ability to defecate. Disturbances of ARM may play an important role in patients with severe ICC. When evaluating anorectal function in children with chronic constipation, more attention should be paid to ARM and fecodynamics.
authors.affiliation: Central Clinical Laboratory, Akita University School of Medicine, Akita, Japan. kayaba@hos.akita-u.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kayaba
authors.forename: Tatsuzo
authors.initials: T
authors.lastname: Hebiguchi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yoshino
authors.forename: Masaru
authors.initials: M
authors.lastname: Mizuno
authors.forename: Norihiro
authors.initials: N
authors.lastname: Saitoh
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Adachi
authors.forename: Junichi
authors.initials: J
authors.lastname: Chihara
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Kato
mesh_terms: D000293:Adolescent; D001003:Anal Canal / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003248:Constipation / Q000503:physiopathology*; D003672:Defecation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009119:Muscle Contraction; D011312:Pressure; D012007:Rectum / Q000503:physiopathology*