Comparative study of anorectal pressures in spastic cerebral palsy children with constipation and without constipation

Abstract

Comparison of internal anal sphincter pressures in spastic cerebral palsy (CP) children with constipation and without constipation. Our study included 65 spastic CP children between 1–14 yr of age. Children having multiple congenital anomalies and with other causes of constipation were excluded. Basal anorectal pressures at the internal anal sphincter at rest were recorded. Majority (67.7%) of cases were in the age group of 1–5 yr. Majority (50.7%) were spastic quadriplegic. Perinatal risk factors accounted for 86.2% of the cases, birth asphyxia being the commonest (67.9%). Seizures were significantly high (P = 0.019) in children with constipation. The mean of maximum, (P < 0.002), mean of minimum (P < 0.005) and the mean of mean anorectal pressures (P < 0.002) were significantly high in spastic children with constipation. Increased anorectal pressures may be an important cause of constipation in children with spastic CP and anorectal manometry should be carried out in these children to rule out increased pressures at the anorectal level.