Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 22 January 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Anorectal manometry does not improve treatment of severe childhood constipation

Anorectal manometry does not improve the outcome of treatment in chronically constipated children, claims a team from the Netherlands.

News image

fiogf49gjkf04

The researchers evaluated the effect of anorectal manometry on the outcome of treatment in severe childhood constipation.

They reported their findings in the July issue of Pediatrics.

212 constipated children (143 boys), who were visiting a referral pediatric gastroenterologic practice, were enrolled in the study.

Each child was prospectively randomized to conventional treatment alone (CT, 115 patients) or to conventional treatment combined with 2 manometry sessions (CTM, 97 patients). Conventional treatment comprised of dietary advice, a daily diary, toilet training, oral laxatives, and enemas.

Successful treatment was defined as a defecation frequency of 3 or more per week, and less than 1 soiling/encopresis episode per 2 weeks, and no use of laxatives.

Success rates at 6, 26, 52 and 104 weeks' follow-up:
CT: 4%, 24%, 32%, and 43%
CTM: 7%, 22%, 30%, and 35%
Pediatrics

Only 4 children from the CT group and 2 from the CTM group showed no soiling and/or encopresis. However, 76% and 65%, respectively, reported the periodic passage of large stools.

In 26% and 30% of the patients, a rectal scybalum was found on physical examination.

The success rates at 6, 26, 52, and 104 weeks' follow-up were 4%, 24%, 32%, and 43% in the CT group. These were 7%, 22%, 30%, and 35% in the CTM group, respectively.

No significant difference in success percentage was observed between the 2 groups at any time of follow-up. The relative risks (CT/CTM) at 6, 26, 52, and 104 weeks' follow-up, were 0.55, 1.13, 1.07, and 1.23, respectively.

A significant increase in defecation frequency was observed between the first and second visits. This was sustained at all subsequent visits and stages of follow-up in both groups, but was not significant.

The researchers found that there was also a significant decrease in encopresis episodes after the first visit. There was a further slow but significant decrease at 52 weeks of follow-up, in both groups.

The manometric data obtained from the CTM group showed a low percentage (28%) of children with normal defecation dynamics. This increased to 38% at the last manometry.

Anorectal manometry combined with CT, compared with CT alone, did not result in higher success rates in chronically constipated children, the authors concluded.

Rijk van Ginkel, of Emma Children's Hospital, Amsterdam, said on behalf of the group, "Anorectal manometry has no additional demystifying or educational effect on clinical outcome in chronically constipated children.

"This observation leaves no diagnostic or therapeutic role for anorectal manometry in chronically constipated children, except its use as a diagnostic test to exclude Hirschsprung's disease."

"A simple CT is successful in 30% of severely constipated children who are referred to a tertiary hospital, underscoring the importance of long-lasting and adequate laxative treatment," it was concluded.

Pediatrics 2001; 108 (1): e9
17 July 2001

Go to top of page Email this page Email this page to a colleague

 22 January 2018 
Costs of biologic therapies for IBD in the USA
 22 January 2018 
Western vs Asian guidelines for colon cancer management
 22 January 2018 
Improving symptoms in GERD
 19 January 2018 
Ileoanal pouch microbiota
 19 January 2018 
Predicting the risk of early surgery in Crohn’s
 19 January 2018 
Lifestyle intervention vs gastric bypass for obesity and diabetes
 18 January 2018 
Healthcare costs of liver cancer in the USA
 18 January 2018 
High-risk adenomas at colonoscopy
 18 January 2018 
Sleeve gastrectomy vs Roux-en-Y gastric bypass
 17 January 2018 
“Weekend effect” in upper GI hemorrhage
 17 January 2018 
Gut dysbiosis and non-antibiotic prescription medications
 17 January 2018 
Reducing surgical infections in high-outlier colorectal unit
 16 January 2018 
Bundle of care in GI cancer surgery
 16 January 2018 
Anxiety about colonoscopy
 16 January 2018 
Thiopurines and colorectal neoplasia in IBD
 15 January 2018 
Risks of death after liver transplants for liver cancer
 15 January 2018 
Recent advances in hepatocellular carcinoma
 15 January 2018 
Ileostomy output using telemedicine
 12 January 2018 
Surveillance protocols after colorectal cancer resection
 12 January 2018 
Biologic therapy by pregnant women with IBD and infant vaccines
 12 January 2018 
Biologic therapies for IBD in the USA
 11 January 2018 
Genetic risk factors in GERD
 11 January 2018 
Predictor of colorectal adenoma
 11 January 2018 
Ectopic pregnancy in IBD 
 10 January 2018 
Fecal immunochemical tests for colorectal cancer screening
 10 January 2018 
Risk factors for advanced NAFLD
 10 January 2018 
Dyspepsia prevalence with gastroesophageal reflux–type symptoms
 09 January 2018 
Screening intervals for people with family histories of colorectal cancer
 09 January 2018 
Financial impact of colorectal cancer
 09 January 2018 
Current practice and future research in autoimmune hepatitis
 08 January 2018 
Reliability of the IBD index
 08 January 2018 
Improving prognosis in patients with primary sclerosing cholangitis
 08 January 2018 
Aprepitant and nausea with gastroparesis
 05 January 2018 
Autoimmune pancreatitis and IBD
 05 January 2018 
Primary nonresponse to infliximab therapy
 05 January 2018 
Anesthesia assistance in outpatient colonoscopy
 04 January 2018 
Dietary polyphenols in the etiology of IBD
 04 January 2018 
Local esophageal food allergen injections in eosinophilic esophagitis
 04 January 2018 
Yoga vs low-FODMAP in IBS
 03 January 2018 
Population health management for IBD
 03 January 2018 
GERD in asthma and COPD
 03 January 2018 
Critical research gaps in colorectal cancer
 22 December 2017 
Costs of extrahepatic manifestations of Hep C
 22 December 2017 
Cholera vaccine and risk of death in colorectal cancer
 22 December 2017 
Colonoscopy after colorectal cancer resection
 21 December 2017 
Human oral microbiome and pancreatic cancer risk
 21 December 2017 
Health management for IBD
 21 December 2017 
PPI and Alzheimer's disease
 20 December 2017 
Management of abnormal liver blood tests
 20 December 2017 
Incidence of biopsy-verified celiac disease
 20 December 2017 
Osteoporotic fractures in Barrett's esophagus
 19 December 2017 
Alcohol abstinence and alcoholic hepatitis
 19 December 2017 
Family burden of pediatric Crohn's in the USA
 19 December 2017 
Early readmission in IBD patients
 18 December 2017 
Colorectal cancer mortality with low-risk adenomas at colonoscopy
 18 December 2017 
Disease activity indices in celiac disease
 18 December 2017 
Smoking behaviour predicted the risk of surgery in Crohn's
 15 December 2017 
Molecular classification of Crohn's disease
 15 December 2017 
Medical cannabinoid legalization policy and vomiting
 15 December 2017 
Inflammatory diet pattern and colorectal cancer risk

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us