title: Anorectal motility abnormalities in children with encopresis and chronic constipation.
abstract: OBJECTIVE
  To evaluate the response to rectal distension in children with chronic constipation and children with chronic constipation and encopresis.
  
  
  METHODS
  We studied 27 children, aged 3 to 16 years, with chronic constipation; 12 had encopresis. Anorectal motility was measured with a solid state catheter. When the catheter was located in the internal sphincter, the balloon was inflated to 60 mL with air.
  
  
  RESULTS
  There were no differences in age, sex distribution, and duration of constipation in the two groups. Comparing groups, anorectal manometry showed no differences in the resting sphincter pressure, recovery pressure, the lowest relaxation pressure, and percent relaxation. However, time to maximum relaxation, time to recovery to baseline pressure, and duration of relaxation were significantly higher in patients with constipation and encopresis, compared with patients who had constipation alone.
  
  
  CONCLUSIONS
  There may be an imbalance in neuromuscular control of defecation in constipated patients with encopresis that results in incontinence as a consequence of the increased time to recovery and duration of relaxation of the internal anal sphincter.
authors.affiliation: Department of Pediatrics, Division of Gastroenterology and Nutrition, New York Medical College, Valhalla, NY 10532, USA.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Raghunath
authors.forename: Mark S
authors.initials: MS
authors.lastname: Glassman
authors.forename: Michael S
authors.initials: MS
authors.lastname: Halata
authors.forename: Stuart H
authors.initials: SH
authors.lastname: Berezin
authors.forename: Julian M
authors.initials: JM
authors.lastname: Stewart
authors.forename: Marvin S
authors.initials: MS
authors.lastname: Medow
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001003:Anal Canal / Q000002:abnormalities / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D003248:Constipation / Q000150:complications / Q000175:diagnosis*; D004688:Encopresis / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D012007:Rectum / Q000002:abnormalities; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors