Anorectal Manometry Results in Defecation Disorders

At What Age Is a Suction Rectal Biopsy Less Likely to Provide Adequate Tissue for Identification of Ganglion Cells?

“…Constipation accounts for 3% of visits to a general pediatrician's office and 25% of visits to a pediatric gastroenterologist (6). Ninety-five percent of children with chronic constipation have functional constipation, and only %5% have an organic cause for their symptoms (7).…”

New Insight into Rectal Function in Pediatric Defecation Disorders: Disturbed Rectal Compliance is an Essential Mechanism in Pediatric Constipation

“…8,18 It should be emphasized that in those studies rectal sensitivity was assessed using volume-controlled distention. Our choice of the barostat was confirmed when we determined the volume in the barostat balloon at the pressure threshold of urge to defecate.…”

“…4 In contrast, abnormal rectal sensitivity has been reported in 27% to 78% of children with PC. 8,9 In these studies, sensitivity was tested by distending the rectum with increasing volumes (ie, anorectal manometry). To date, it is known that pressure/tension, not volume, mainly determines visceral perception.…”

The Physiology of Human Defecation

“…Nevertheless, the clinical importance of impaired peripheral sensations in children has been questioned [30]. Although earlier studies reported that larger rectal distension volumes were needed to trigger rectal sensation in constipated children [227,228], more recent studies found no difference in sensory function in children with functional constipation when compared to healthy volunteers [229,230], although rectal compliance (stretch response to an imposed force) was greater (i.e. the rectum was more lax) in constipated individuals.…”