[The value of anorectal manometry as differentiated organic and functional disorders in children and youth with chronic constipation].
Constipation is the most frequent ailment from digestive tract in children and youth. Anorectal manometry is no invasion research, contribute to the explanation of pathomechanisms of defecation disorders.


OBJECTIVE
of our study is the value of anorectal manometry in diagnostics organic and functional constipation in children and youth. MATRIAL AND METHOD: The study was comprised 100 patients, in it 35 girls and 65 boys, aged from 3 to 17 years old (median age 7 years), who were diagnosed and treated in Chair and Clinic of Pediatrics, Allergology and Gastroenterology by the reason of constipation. The difficulties with constipation were kept at least by three months. Among of analyzed patients 64 came from city and 36 came from the country environment. Transit time was measured in all patients by Abrahamsson' method in modification Hinton. In all patients was measured also anorectal manometry and rectoscopy with histological research.


RESULTS
At age group from 3-6 years old and 7-12 years old near 70% were boys. At the group 13-17 years old frequently constipation were in girls (70%). Majority analyzed with constipation in the three groups came from city (group I - 60%, group /II - 71%, group /1/ - 67%). The total colonic transit time was prolonged in 50 (50%) patients with constipation, in 50 (50%) transit time was normal. In 19 patients was the lack of nerve cells in rectum. In 6 patients with the lack of nerve cells in histological research was the lack of rectoanal inhibitory reflex in anorectal manometry. In all patients with presence of nerve cells was RAIR in anorectal manometry. In 66 (66%) children had normal dynamics of defecation. At 34% patients had disturbance of dynamics of defecation (in 21 patients paradoxical shrink of anorectal sphincter, 13 the lack of sphincters relaxation during straining). The organic lesions in anorectal region were in 16 children with constipation. 84 patients granted criteria of functional disorders defecation from 1999 (so called I1 classification of roman functional disturbance). There were not observed essential statistically differences in frequency paradoxical shrink of sphincter and the lack of sphincters relaxation during straining in the group children with organic and functional constipation (p > 0.05). We were observed strong relationship important statistically between presence nerve cells and presence RAIR (p < or =0.01).


CONCLUSIONS
On the base of conducted analysis may be stated at anorectal manometry is useful research in differentiating the kind of defecation disorders in children and youth, which can limit the range of invasion diagnostic research.
Czerwionka-Szaflarska
Mieczysława
M
Katedra i Klinika Pediatrii, Alergologii i Gastroenterologii. klped@cm.umk.pl.
Zielińska-Duda
Hanna
H
Mierzwa
Grazyna
G
Drewa
Sylwia
S
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003108:Colonic Diseases / Q000150:complications / Q000175:diagnosis*; D003248:Constipation / Q000209:etiology*; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008365:Manometry; D011312:Pressure; D012002:Rectal Diseases / Q000150:complications / Q000175:diagnosis*