scholarly journals Measurement of Rectal Diameter and Anterior Wall Thickness by Ultrasonography in Children With Chronic Constipation

2021 ◽  
Author(s):  
Güzide Doğan ◽  
Merter KEÇELİ ◽  
Sibel Yavuz ◽  
Adem Topçu ◽  
Erhun Kasırga
Keyword(s):  
Wall Thickness ◽  
Chronic Constipation ◽  
Digital Rectal Examination ◽  
Functional Constipation ◽  
Thickness Measurement ◽  
Anterior Wall ◽  
Symphysis Pubis ◽  
Radiology Department ◽  
Control Group ◽  
Rectal Examination

Abstract Introduction: Measurement of rectal diameter by ultrasonograpy helps the clinician in the diagnosis of chronic constipation in children for whom rectal examination cannot be performed. The aim of the study is to determine the rectal diameter and anterior wall thickness values with constipated and healthy subjects, and to evaluate the usability of ultrasonography in the diagnosis of functional constipation in children for whom refuse digital rectal examination Materials and Methods: The constipated group included 140 children, while the control group included 164 children. All patients were divided into four subgroups according to their ages and were referred to the radiology department for rectal measurements. Results: At the symphysis pubis plane the rectal diameter measurement of the constipated patients with fecal retention positive group was statistically greater than the control group. At the ischial spine plane, rectum diameter of constipated children with fecal retention positive or negative was found to be statistically greater than the control group. At the bladder neck plane rectum diameter of constipated patients with fecal retention positive was statistically greater than the control group. Rectum anterior wall thickness measurement was found to be higher in constipated patients with fecal retention positive compared to the control (p = 0.000). It’s measurements of constipated patients in group II, group III, and group IV with empty rectum were found to be statistically higher than the control group. Conclusion: Measurement of rectal diameter and anterior wall thickness by ultrasonograpy as a noninvasive method in children who do not want the digital rectal examination and may be useful in the diagnosis of constipation.

Diagnosis of Megacolon: The Rectal Examination

PEDIATRICS ◽  
1966 ◽  
Vol 37 (3) ◽  
pp. 535-536
Author(s):  
JOHN G. LOEFFLER
Keyword(s):  
Newborn Infant ◽  
Barium Enema ◽  
Chronic Constipation ◽  
Digital Rectal Examination ◽  
Rectal Biopsy ◽  
Functional Constipation ◽  
Diagnostic Dilemma ◽  
Rectal Examination ◽  
Older Child

The following comments pertain to an article in Pediatrics, 36:572, 1965. In their article, "Aganglionic and Functional Megacolon in Children—a Diagnostic Dilemma," Drs. Kottmeier and Clatworthy have done a commendable job in pointing out the pitfalls of diagnosing aganglionic megacolon in the newborn infant. I am afraid, however, that the authors have given the impression that reliance should be made on barium enema and rectal biopsy when distinguishing between aganglionic megacolon and functional constipation in the older child who presents with chronic constipation. In the article no mention was made about the value of a simple digital rectal examination.

scholarly journals Currarino syndrome or Hirschsprung disease: how to prevent diagnostic dilemma in chronic constipation

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Md Mokarram Ali ◽  
Ram Jeewan Singh ◽  
Rashi Rashi ◽  
Amit Kumar ◽  
Amit Kumar Sinha ◽  
...  
Keyword(s):  
Chronic Constipation ◽  
Digital Rectal Examination ◽  
Hirschsprung Disease ◽  
Age Group ◽  
Pediatric Age ◽  
Diagnostic Dilemma ◽  
Common Cause ◽  
Currarino Syndrome ◽  
Rectal Examination ◽  
Pediatric Age Group

Abstract Background Currarino syndrome is a rare congenital malformation having autosomal dominant inheritance. It comprises of anorectal malformation, presacral mass, and sacral vertebral defect occurring in variable proportion. The most common presentation is chronic constipation which is usually due to compression of rectum by anterior sacral mass. If clinical examination is not properly done and digital rectal examination is excluded from the examination, it can be misdiagnosed as other common cause of constipation like Hirschsprung disease. Case presentation We are reporting one such case of one-and-half-year-old female child with chronic constipation which was initially managed as Hirschsprung disease, but later on, after a repeat clinical examination with digital rectal examination, it was evaluated on the line of Currarino syndrome. The diagnosis was confirmed by contrast-enhanced computed tomography of abdomen with 3 dimensional reconstruction. It was then managed by posterior sagittal approach with excision of mass and anorectoplasty. Conclusion A proper protocol for clinical evaluation of patient with constipation prevents diagnostic dilemma between surgical causes of constipation in pediatric age group. Digital rectal examination must be included in the protocol for evaluation of chronic constipation. In pediatric age group, clinical workup should be done with keeping in mind the rare diagnosis of Currarino syndrome along with common cause of constipation like Hirschsprung disease.

scholarly journals Digital Rectal Examination Is a Valuable Bedside Tool for Detecting Dyssynergic Defecation: A Diagnostic Study and a Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jie Liu ◽  
Chaolan Lv ◽  
Yizhou Huang ◽  
Ying Wang ◽  
Dandan Wu ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Digital Rectal Examination ◽  
Functional Constipation ◽  
Cochrane Library ◽  
Diagnostic Study ◽  
Dyssynergic Defecation ◽  
Rectal Examination ◽  
Physiological Tests

Background. Accurate dyssynergic defecation (DD) diagnosis depends on anorectal physiological tests that are not widely available. Aim. The purpose of this study is to evaluate the diagnostic yield of digital rectal examination (DRE) compared with anorectal physiological tests in diagnosing DD in patients with constipation. Methods. A total of 218 chronic constipation patients who fulfilled the Rome IV diagnostic criteria for functional constipation (FC) and underwent a standardized DRE and high-resolution anorectal manometry (HRAM) test were enrolled in this study. The diagnostic accuracy of DRE compared with HRAM was evaluated, and the agreement between DRE and HRAM was calculated. Furthermore, a comprehensive literature search on PubMed, Web of Science, Cochrane Library, and Embase database was conducted to further elucidate the pooled diagnostic accuracy of DRE in DD patients. Results. A total of 101 patients (46.33%) had a DD pattern using HRAM, while 117 patients (53.67%) were diagnosed without DD. The sensitivity of DRE in diagnosing dyssynergia was 71.3%, and the specificity was 76.1%. There was a moderate agreement between DRE and HRAM for diagnosing DD (κ-coefficient = 0.474, P < 0.001 ). Meanwhile, six studies (including our study) comprising 964 constipated patients were included in our meta-analysis. The outcomes demonstrated that the AUC was 0.85 (95% CI 0.82–0.88) with 77% summary sensitivity (95% CI 65–86) and 80% summary specificity (95% CI 71–86) to diagnose DD. Conclusions. DRE could be a valuable tool for screening DD. Our study revealed acceptable sensitivity and specificity of DRE in detecting dyssynergia compared with the physiological tests. Meanwhile, our study highlights that DRE remains an important tool in clinical practice.

scholarly journals Frequency of Digital Rectal Examination in Children With Chronic Constipation

1999 ◽  
Vol 153 (4) ◽  
Author(s):  
David M. Gold ◽  
Jeremiah Levine ◽  
Toba A. Weinstein ◽  
Bradley H. Kessler ◽  
Michael J. Pettei
Keyword(s):  
Chronic Constipation ◽  
Digital Rectal Examination ◽  
Rectal Examination

scholarly journals Paradoxical sphincter contraction is rarely indicative of anismus

Gut ◽  
1997 ◽  
Vol 41 (2) ◽  
pp. 258-262 ◽  
Author(s):  
W A Voderholzer ◽  
D A Neuhaus ◽  
A G Klauser ◽  
K Tzavella ◽  
S A Müller-Lissner ◽  
...  
Keyword(s):  
Chronic Constipation ◽  
Anorectal Manometry ◽  
Digital Rectal Examination ◽  
Common Finding ◽  
Puborectalis Muscle ◽  
Sphincter Pressure ◽  
Healthy Controls ◽  
Rectal Examination ◽  
Stool Incontinence ◽  
Paradoxical Sphincter

Background—Anismus is thought to be a cause of chronic constipation by producing outlet obstruction. The underlying mechanism is paradoxical contraction of the anal sphincter or puborectalis muscle. However, paradoxical sphincter contraction (PSC) also occurs in healthy controls, so anismus may be diagnosed too often because it may be based on a non-specific finding related to untoward conditions during the anorectal examination.Aims—To investigate the pathophysiological importance of PSC found at anorectal manometry in constipated patients and in patients with stool incontinence.Methods—Digital rectal examination and anorectal manometry were performed in 102 chronically constipated patients, 102 patients with stool incontinence, and in 18 controls without anorectal disease. In 120 of the 222 subjects defaecography was also performed. Paradoxical sphincter contraction was defined as a sustained increase in sphincter pressure during straining. Anismus was assumed when PSC was present on anorectal manometry and digital rectal examination and the anorectal angle did not widen on defaecography.Results—Manometric PSC occurred about twice as often in constipated patients as in incontinent patients (41.2% versus 25.5%, p<0.017) and its prevalence was similar in incontinent patients and controls (25.5% versus 22.2%). Oroanal or rectosigmoid transit times in constipated patients with and without PSC did not differ significantly (total 64.6 (8.9) hours versus 54.2 (8.1) hours; rectosigmoid 14.9 (2.4) hours versus 13.8 (2.5) hours).Conclusions—Paradoxical sphincter contraction is a common finding in healthy controls as well as in patients with chronic constipation and stool incontinence. Hence, PSC is primarily a laboratory artefact and true anismus is rare.

Correction of functional constipation in patients with limited mobility after stroke

2019 ◽  
Vol 1 (6) ◽  
pp. 53-55
Author(s):  
M. S. Turchina ◽  
M. V. Bukreeva ◽  
L. Yu. Korolyova ◽  
Zh. E. Annenkova ◽  
L. G. Polyakov
Keyword(s):  
Quality Of Life ◽  
Chronic Constipation ◽  
Functional Constipation ◽  
Cerebrovascular Diseases ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Limited Mobility ◽  
Complete Restoration ◽  
The World

Currently, the problem of early rehabilitation of stroke patients is important, since in terms of the prevalence of cerebrovascular diseases and disability after suffering a stroke, Russia is one of the first places in the world. The complex of medical rehabilitation of such patients should provide for the early and most complete restoration of all body functions, patient education for lost skills, re-socialization of the patient and improvement of the quality of life. One of the factors contributing to a significant reduction in the quality of life after a stroke is the development of chronic constipation. The article reflects the modern methods of correction of chronic constipation in patients with limited mobility.

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