Functional constipation in children: investigation and management of anorectal motility.
BACKGROUND
Constipation is a common disease in children. Despite many causes, constipation is most often functional. This study was undertaken to investigate the anorectal motility in children with functional constipation as compared with healthy children and to determine the efficacy of management based on the results of anorectal manometry.


METHODS
A multi-functional manometry was used to detect the anorectal manometry indexes of 8 patients with functional constipation (11.4+/-4.8 years) as well as those of 10 healthy children (10.5+/-3.5 years) from May 2004 to June 2005. The patients received a combined treatment regimen including probiotics (bifid triple viable bacterial tablet), prebiotics (lactulose) and regular defecation according to the results of anorectal manometry. The efficacy of these conservative measures was estimated during the course of treatment.


RESULTS
No statistical difference was found in the indexes of effective length of the anal sphincter, anal tract maximal systolic pressure and the duration of more than 50% maximal systolic pressure between the two groups. But minimal sensitivity and maximal tolerated volume between the two groups were different significantly. Seven of the eight patients got better with the conservative treatment.


CONCLUSIONS
Abnormalities exist in the anorectal motility of the children with functional constipation. Conservative treatment regimen based on the results of anorectal manometry is significantly effective.
Li
Zheng-Hong
ZH
Department of Pediatrics, PUMC Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. worldlizhengh@yahoo.com.cn
Dong
Mei
M
Wang
Zhi-Feng
ZF
D000293:Adolescent; D001003:Anal Canal / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000503:physiopathology* / Q000628:therapy; D003672:Defecation; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007792:Lactulose / Q000627:therapeutic use; D008297:Male; D008365:Manometry; D019936:Probiotics / Q000627:therapeutic use; D012007:Rectum / Q000503:physiopathology*; D013997:Time Factors
D005765:Gastrointestinal Agents; D007792:Lactulose