Do we need an extra dimension? A pilot study on the use of three‐dimensional anorectal manometry in children with functional constipation

Baaleman, Desiree F.; Vriesman, Mana H.; Benninga, Marc A.; Bali, Neetu; Vaz, Karla; Yacob, Desale; Lorenzo, Carlo Di; Lu, Peter L.; Koppen, Ilan J.N.

doi:10.1111/nmo.14370

Cited by 2 publications

(2 citation statements)

References 29 publications

(65 reference statements)

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“…The manometric catheter used for anorectal manometry has become more sophisticated over time, advancing from water‐perfused catheters to solid‐state high‐resolution catheters to more recent three‐dimensional high‐definition catheters allowing circumferential recording of the pressures generated by the anal sphincter complex (Figure 1). Although three‐dimensional evaluation is felt to be helpful for children who have undergone surgery on the anorectum, the additional utility of a third dimension compared to two‐dimensional high‐resolution anorectal manometry for children with functional constipation is less clear 10,11 …”

Section: Discussionmentioning

confidence: 99%

“…Although three-dimensional evaluation is felt to be helpful for children who have undergone surgery on the anorectum, the additional utility of a third dimension compared to two-dimensional high-resolution anorectal manometry for children with functional constipation is less clear. 10,11 Anorectal manometry can be difficult to perform for younger or uncooperative children. For these children, testing can be performed with sedation or while under anaesthesia, which limits the study to the assessment of the anal canal resting pressure and the RAIR.…”

Section: Anorectal Manometrymentioning

confidence: 99%

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Management of the child with refractory constipation

van der Zande,

2024

Aliment Pharmacol Ther

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SummaryBackgroundCaring for children with constipation refractory to conventional treatment can be challenging and management practices vary widely.AimsTo review recent advances in the evaluation and treatment of children with refractory constipation and to propose an algorithm that incorporates the latest evidence and our institutional experience.MethodsWe performed a literature review on diagnostic tests and treatment options for children with refractory constipation.ResultsEvaluation of a child with refractory constipation seeks to better understand factors contributing to an individual child's presentation. Anorectal manometry evaluating for a rectal evacuation disorder and colonic manometry evaluating for colonic dysmotility can guide subsequent treatment. For the child who has not responded to conventional treatment, a trial of newer medications like linaclotide can be helpful. Transanal irrigation offers a safe and effective alternative for families able to administer daily rectal treatment. Despite mixed evidence in children, pelvic floor biofeedback therapy can help some children with pelvic floor dyssynergia. For younger children unable to cooperate with pelvic floor therapy, or older children with refractory symptoms, internal anal sphincter botulinum toxin injection can be beneficial. Antegrade continence enema treatment can be effective for children with either normal colonic motility or segmental dysmotility. Sacral nerve stimulation is generally reserved for symptoms that persist despite antegrade continence enemas, particularly if faecal incontinence is prominent. In more severe cases, temporary or permanent colonic diversion and segmental colonic resection may be needed.ConclusionsRecent advances offer hope for children with refractory constipation.

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Section: Discussionmentioning

confidence: 99%

Section: Anorectal Manometrymentioning

confidence: 99%