Rectoanal Pressure and Rectal Compliance in Constipated Infants and Children

Abstract

Anorectal manometry with perfused side opening catheter was carried out in 86 normal infants and children, 9 infants with Hirschsprung's disease, and 10 children with idiopathic chronic constipation. Studies on pressure volume curve of the rectum and rectal compliance were carried out in 37 normal infants and children, 4 infants with Hirschsprung's disease, and 10 children with idiopathic chronic constipation. Decreased basal rhythmic contraction of the anal canal, absent recto-anal reflex, steep elevation of pressure volume curve of the rectum and low rectal compliance were characteristic in infants with Hirschsprung's disease. Resting pressure profile of the anorectum, recto-anal reflex, pressure volume curve of the rectum and rectal compliance were normal in chronically constipated children without mega-rectum, whereas remarkably slow elevation of pressure volume curve of the rectum and high rectal compliance was characteristic in those with megarectum. Normal resting pressure profile of the anorectum and abnormally high rectal compliance seen in constipated children with megarectum suggest that this type of constipation is a result of primary rectal ectasia, whereas normal resting pressure profile and rectal compliance in constipated children without megarectum indicate that constipation is a result of disturbed motility of the colon in these patients.