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Anorectal manometric examination in encopretic-constipated children

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: We have investigated the use of anorectal manometry to distinguish encopretic-constipated children (n=88) from sibling controls (n=16) and nonsibling controls (n=11). METHODS: Study variables included manometrically determined resting and maximum voluntary anal sphincter pressure, depth and speed of rectoanal inhibitory reflex, minimum rectal volume sensation, critical distending volume for fecal urgency, rectal and anal pressure responses during attempted defecation, and ability to defecate a water-filled balloon. RESULTS: Change in anal sphincter pressure during attempted defecation (P=0.03), gradient between rectal and sphincter pressure during attempted defecation (P=0.02), critical distending volume for fecal urgency (P=0.02), and ability to defecate a water-filled balloon (P=0.05) distinguished encopretic-constipated from control children. The change in rectal pressure associated with the rectoanal inhibitory reflex just escaped significance at P=0.07. CONCLUSIONS: Anal sphincter spasm and megacolon are pathophysiologic abnormalities associated with pediatric constipation-encopresis.

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Authors and Affiliations

  1. Departments of Pediatrics and Behavioral Medicine, University of Virginia Health Sciences Center, Charlottesville, Virginia

    James Sutphen M.D., Ph.D., Stephen Borowitz M.D., William Ling Ph.D., Daniel J. Cox Ph.D. & Boris Kovatchev Ph.D.

Authors
  1. James Sutphen M.D., Ph.D.
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  2. Stephen Borowitz M.D.
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  3. William Ling Ph.D.
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  4. Daniel J. Cox Ph.D.
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  5. Boris Kovatchev Ph.D.
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Additional information

Supported by National Institutes of Health grant RO1 HD 28160, CB Fleet Co., Inc., Lynchburg, Virginia—Fleet® Ready-to-use enemas, and Sterling Winthrop, Inc., New York, New York-Phillips® Milk of Magnesia.

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Sutphen, J., Borowitz, S., Ling, W. et al. Anorectal manometric examination in encopretic-constipated children. Dis Colon Rectum 40, 1051–1055 (1997). https://doi.org/10.1007/BF02050928

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  • DOI: https://doi.org/10.1007/BF02050928

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