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Clinical significance of anismus in encopresis
Author(s) -
CATTOSMITH ANTHONY G,
NOLAN TERENCE M,
COFFEY CAROLYN MM
Publication year - 1998
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1998.tb00768.x
Subject(s) - medicine , encopresis , mesocyclone , surgery , constipation , doppler effect , physics , doppler radar , astronomy
Treatments designed to relieve paradoxical contraction of the anal sphincters during defecation (anismus) have had limited success in children with encopresis. This has raised doubts as to the clinical relevance of this diagnosis in childhood as anorectal dysfunction. Our aim was to determine whether, in patients who had treatment‐resistant encopresis, the presence of electromyographic anismus was associated with increased faecal retention. Sixty‐eight children with soiling (mean age 8.7 ± 2.06 years) were assessed by clinical examination, abdominal radiography and then with anorectal manometry. Patients with electromyographic anismus ( n = 32; 47%) had significantly increased radiographic rectal faecal retention and were significantly less likely to be able to defecate water‐filled balloons. There were no significant differences in response to prior therapy, history of primary encopresis, behavioural adjustment or in sociodemographic data. Our results suggest that electromyographic anismus is associated with obstructed defecation and faecal retention.