Functional constipation in children: investigation and management of anorectal motility

Abstract

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. 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. 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. 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.