Treatment of constipation in children based on anorectal manometery findings

Abstract

Background: Constipation is a common symptom in children and manometery can be a useful diagnostic method in choosing suitable therapeutic methods for these patients. Aim: The aim of this study was to assess the manometeric findings and determine its role in the management of children with constipation referred to our hospital. Setting and Design: This was a descriptive cross-sectional study. Materials and Methods : It was carried out on patients referred from September 2006 to December 2009 to the children hospital for performance of anorectal manometery because of constipation. They received their treatment according to findings at manometry (normal, absent, dilated, and retentive) with Botolinium toxin (BT) injection, surgery, enema, and medications, respectively. For each patient, variables such as age, sex, chief complaint, manometry result, food regimen, and treatment method were recorded. Symptom severity scale was assessed using a scored questionnaire. Statistical Analysis: Data were analyzed using SPSS 17 and descriptive statistics, t-test, and χ2 . Results: Seventy-one patients were included in our study. The mean age of the participants was 4.98 ΁ 1.43. Sixteen (22.5%) had acute and 55 (77.5%) had chronic constipation. Seventeen (25.4%) had a diagnosis of Hirschsprung′s disease and 22 patients (31%) had retentive type constipation. Nineteen patients (28.8%) received pull through treatment and 27 (38%) received BT, while 34 (47.9%) received medical treatment. Mean symptom severity score after treatment was 3.88 and 4.59 in males and females, respectively. This difference was statistically significant (P = 0.03). There was no statistically significant difference after treatment according to other variables. Conclusions : In summary, our study results were comparable with studies that reported an effective role for manometry in diagnosis and planning the type of treatment in constipated children. and is a useful physiologic tool for measuring anorectal complex function.