A new ultrasound scoring system for assessing the severity of constipation in children.
OBJECTIVE
Pelvic ultrasound (US) has been used in various different ways to assess severity of constipation. We evaluated the use of a new US scoring system to determine if there is any correlation between symptom severity and US findings.


METHODS
Data were collected prospectively on all children attending the constipation clinic from January 2007 to July 2008. All patients completed a standardised symptom severity score sheet (SSS) for constipation. US was done with the probe placed 2 cm above the pubic symphysis. A new US scoring system designed to assess the faecal loading and its effect on the bladder was used. Patients with severe symptoms were followed up with few patients requiring as many as four follow up visits. During each follow-up visit SSS and US scoring was completed.


RESULTS
A total of 500 patients were studied (male 317, female 183) with a median age of 8 years (8 months, 18 years). Statistical analysis was done using SPSS software (version 15.0). Pearson's correlation was used to assess the correlation between SSS and US score. P value <0.05 was considered to represent a statistically significant correlation between symptoms and ultrasound findings.


CONCLUSIONS
US is an easy and quick tool that can be used in the out-patient setting to assess severity of constipation. The new US scoring system is a reliable method that can be used in conjunction with clinical examination for assessing the long-term improvement of children who are undergoing treatment for chronic constipation.
Lakshminarayanan
Bhanumathi
B
Paediatric Intestinal Motility Unit, Evelina Children's Hospital, Guy's & St Thomas' NHS Trust, Westminster Bridge Road, London, SE1 7EH, UK. bhanumathi1979@hotmail.com
Kufeji
Dorothy
D
Clayden
Graham
G
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000145:classification / Q000000981:diagnostic imaging*; D005243:Feces; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012007:Rectum / Q000000981:diagnostic imaging; D012720:Severity of Illness Index; D014463:Ultrasonography