Letter to the Editor

Abstract

With great interest we read the article by Borg et al. showing long-term bowel functional outcomes in children with anorectal malformation (ARM) and megarectosigmoid (MRS) [ [1] Borg H. Bachelard M. Sillen U. Megarectosigmoid in children with anorectal malformations: long term outcome after surgical or conservative treatment. J Pediatr Surg. 2014; 49: 564-569 Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar ]. The study noted that early implementation of bowel management could provide comparative results to surgical treatment. This finding is identical to our own experience. Since MRS congenitally exists in the majority of ARMs, constipation may occur soon after anorectal reconstruction, even within a few weeks. If constipation cannot be detected early and properly managed, there will be a vicious cycle with fecal accumulation dilating the rectum, subsequently worsening the constipation. With regular emptying of the colon, we have seen good bowel function in MRS allowing decreased dosage or cessation of laxatives in good-prognosis ARMs. Reply to Letter to the EditorJournal of Pediatric SurgeryVol. 50Issue 6PreviewWe greatly appreciate the letter to the Editor by Drs. Chin-Hung Wei, Yu-Wei Fu, and Yong Wang commenting on our article and providing additional information from their own experience of conservative treatment of MRS. Their results also support our findings. Full-Text PDF