Changes of Anorectal Motility in Children with Functional Constipation before and after Treatment

Objective To investigate the changes of anorectal manometry and colonic transit test in children with functional constipation(FC)before and after therapy.Methods Thirty-five children with FC in Tangdu Hospital from Jan.2008 to Dec.2009 were collected as FC group.At the same period,10 children with no digestive system symptoms and daily normal defecation were selected as healthy control group.Colonic transit index(TI)determined by X ray opaque markers(ROM)was used to classify the FC type,the FC children were divided into slow transit(STC)type and outlet obstruction(OOC)type.With the adoption of the Dutch MMS company's Solar GI gastrointestinal dynamic inspection system to measure indicators of anorectal manometry,FC group was treated with Polyethylene Glycol 4000 powder to observe the efficacy and to test the changes of anorectal manometry before and after treatment.Results There were no significant difference between FC group and healthy control group as well as the groups of 2 types of FC in anal sphincter resting pressure(Pa0.05).Anal sphincter maximum systolic blood pressure in OOC group were higher than those in healthy control group and STC group,which had a significant difference(Pa0.05).The lowest rectal volume and maximum tolerated dose-sensitive in FC group were higher than those in healthy control group and there were significant difference(Pa0.05).There was no significant difference before and after treatment between STC group and OOC group in anal sphincter resting pressure and anal sphincter maximum systolic blood pressure(Pa0.05).After treatment,compared with healthy control group,FC group had no significant differences in anal sphincter resting pressure,anal sphincter maximum systolic blood pressure and rectal maximum tolerated dose(Pa0.05).There existed significant differences in rectal sensitive to the amount of the minimum between OOC group after treatment and healthy control group(P0.05).Conclusions Children with FC have an obvious dysfunction of dynamics and anorectal anomalies and colonic transit.Polyethylene Glycol 4000 powder treatment can improve this abnormality.