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High‐resolution anorectal manometry in children with functional constipation with or without fecal incontinence
Author(s) -
Alessandrella Annalisa,
Turco Rossella,
Russo Marina,
Poziello Antonio,
Miele Erasmo,
Staiano Annamaria
Publication year - 2020
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13882
Subject(s) - anorectal manometry , medicine , asymptomatic , fecal incontinence , anal canal , functional constipation , constipation , high resolution manometry , population , limits of agreement , gastroenterology , rectum , nuclear medicine , reflux , disease , environmental health
Background High‐resolution anorectal manometry (HR‐ARM) is expected to be better than conventional manometry. Our aim was to characterize HR‐ARM pressures in children with functional constipation (FC), with or without fecal incontinence (FI). Methods Children with diagnosis of FC, with or without FI, according to Rome‐IV criteria, were enrolled. All patients underwent HR‐ARM using 24‐channel water‐perfused catheter. Results Twenty‐nine consecutive children (M/F: 21/8; mean age ± SD: 9.5 ± 3.1 years; range 4‐15), of whom 21 affected by FC without FI (mean age ± SD: 9.3 ± 3.23 years) and 8 affected by FC with FI (mean age ± SD: 10.2 ± 3.08 years), were enrolled. No significant differences were found regard to gender and age. The analysis of HR‐ARM 3D plots demonstrated asymmetry of the anal canal, with higher pressures in distal halves. Comparing pressures between the two groups, we found lower values in FC with FI than in FC without FI group, with a statistically significance for maximum and mean resting pressures ( P = .032 and P = .008, respectively). When evaluating our study population respect to asymptomatic children, we found lower resting pressures, lower maximum squeeze pressure, and higher rectoanal inhibitory reflex (RAIR) values. Conclusions Our data demonstrate that HR‐ARM pressures at rest and during squeezing in FC with FI children are lower than FC without FI subjects, particularly in anteroposterior quadrants. Compared to children without lower gastrointestinal symptoms, children with FC with or without FI show lower pressures and higher values of RAIR.