Anismus as a cause of functional constipation: Experience from Serbia

Backround/Aim. Anismus is paradoxal pressure increase or pressure decrease less than 20% of external anal sphincter during defecation straining. This study analyzed the presence of anismus as within a group of patients with the positive Rome III criteria for functional constipation. We used anorectal manometry as the determination method for anismus. Methods. We used anorectal waterperfused manometry in 60 patients with obstructive defecation defined by the Rome III criteria for functional constipation. We also analyzed anorectal function in 30 healthy subjects. Results. The presence of anismus is more frequent in the group of patients with obstructive defecation compared to the control group (a highly statistically significant difference, p < 0.01). Furthermore, we found that the Rome III criteria for functional constipation showed 90% accuracy in predicting obstructive defecation. We analyzed the correlation of anismus with the presence of weak external anal sphincter, rectal sensibility disorders, enlarged piles, diverticular disease and anatomic variations of colon. We found no correlation between them in any of these cases. Conclusion. There is a significant correlation between anismus and positive Rome III criteria for functional constipation. Anorectal manometry should be performed in all patients with the positive Rome III criteria for functional constipation.

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Anorectal manometry in children with chronic functional constipation

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032005000300010 ◽

2005 ◽

Vol 42 (3) ◽

pp. 178-181 ◽

Cited By ~ 5

Author(s):

Rosa Helena Monteiro Bigélli ◽

Maria Inez Machado Fernandes ◽

Yvone Avalloni de Moraes Villela de Andrade Vicente ◽

Roberto Oliveira Dantas ◽

Lívia Carvalho Galvão ◽

...

Keyword(s):

Anal Sphincter ◽

Anorectal Manometry ◽

External Anal Sphincter ◽

Standard Treatment ◽

Functional Constipation ◽

Residual Pressure ◽

Rectal Distension ◽

Normal Children ◽

Basal Pressure ◽

Before And After

BACKGROUND: The anorectal manometry is a very utilized and well recognized examination in children with chronic funcional constipation. The major manometric findings in these children are: anal hypotonia, anal hypertonia, paradoxal contraction of the external anal sphincter, decreased ability of internal anal sphincter to relax during rectal distension and alterations in rectal contractility, sensibility and compliance. AIMS: To evaluate the anal basal pressure and the relaxation reflex before and after standard treatment for a better understanding of the physiopathologic mechanisms involved in pediatric chronic functional constipation. METHODS: Anorectal manometry was performed before treatment on 20 children with chronic functional constipation aged 4 to 12 years and the results were compared to those obtained after standard treatment, with a good outcome. RESULTS: There was a reduction in anal basal pressure after treatment, but no differences were detected between the anorectal manometries performed before and after treatment in terms of amplitude and duration of relaxation, residual pressure, latency time, or descent and ascent angle. CONCLUSIONS: We conclude that the anal basal pressure decreased in children recovering from chronic functional constipation, but the standard treatment did not provide all the conditions necessary for the relaxation reflex of constipated children to return to the values described in normal children.

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ULTRASONOGRAPHY IN DETERMINING THE RECTAL DIAMETER AND RECTAL WALL THICKNESS IN CHILDREN WITH AND WITHOUT CONSTIPATION: A CASE-CONTROL STUDY

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201900000-19 ◽

2019 ◽

Vol 56 (1) ◽

pp. 84-87 ◽

Cited By ~ 2

Author(s):

Mohammad MOMENI ◽

Mohammad MOMEN-GHARIBVAND ◽

Niloofar KULOUEE ◽

Hazhir JAVAHERIZADEH

Keyword(s):

Wall Thickness ◽

Rectal Wall ◽

Control Group ◽

Rome Iii Criteria ◽

Abdominal Sonography ◽

Full Bladder ◽

Significant Difference ◽

Rome Iii ◽

Transabdominal Sonography ◽

Control Study

ABSTRACT BACKGROUND: Ultrasonography has shown to be useful in the diagnosis of constipation. OBJECTIVE: The aim of this study was to compare the rectal diameter and rectal wall thickness in children with and without constipation. METHODS: Children with the diagnosis of constipation according to Rome III criteria were included in the study. The children underwent transabdominal sonography for the evaluation of rectal diameter and rectal wall thickness. Ultrasonography was performed with a full bladder. Children without constipation who underwent abdominal sonography were assigned to the control group. RESULTS: The rectal diameter was larger in children with constipation than in children without constipation (31.72±9.63 mm vs 19.85±4.37 mm; P=0.001). The rectal wall was thinner in children with constipation than in children without constipation (1.75±0.33 mm vs 1.90±0.22 mm; P=0.032). There was no significant difference between boys and girls with constipation in terms of rectal diameter (31.02±8.57 mm 32.77±11.35 mm; P=0.63). CONCLUSION: Transabdominal rectal diameter measurement may be useful in the diagnosis of constipation.

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Changes in the parameters of the rectoanal inhibitory reflex in children with functional constipation and large rectum

Medicine and Pharmacy Reports ◽

10.15386/mpr-1894 ◽

2021 ◽

Author(s):

Daniela Pop ◽

Simona Tătar ◽

Otilia Fufezan ◽

Dorin Farcău

Keyword(s):

Anorectal Manometry ◽

Functional Constipation ◽

Abdominal Ultrasound ◽

Mean Value ◽

Control Group ◽

Transverse Diameter ◽

Rectoanal Inhibitory Reflex ◽

Secondary Objective ◽

The Mean ◽

Inhibitory Reflex

Background. Abdominal ultrasound and anorectal manometry are part of the investigations used to assess children with functional constipation. This study aimed at assessing the changes in the characteristics of the rectoanal inhibitory reflex (RAIR) in children with functional constipation and correlating them with the dimensions of the rectum, measured by abdominal ultrasound. A secondary objective was to compare the rectum size in children with and without constipation. Method. We retrospectively reviewed the clinical data and investigations results of 51 children (mean age±standard deviation (SD) =5.8±3.5 years) with functional constipation who came to our clinic between January 2013 and February 2020. The assessment of these patients included both the assessment of the transverse diameter of the rectal ampulla by abdominal ultrasound and anorectal manometry. The studied parameters of RAIR were: the minimal volume of air necessary to induce RAIR, in all the patients with functional constipation, and in 20 of them, relaxation time, latency and relaxation percentage. A control group was formed of 27 children (mean age±DS=5.1±4 years) without digestive diseases and with normal intestinal transit, who were assessed by abdominal ultrasound. Results. The mean value ±SD of the volume of air necessary to induce RAIR was 21.9±12.1 cm3 air. There was no correlation between the rectum transverse diameter and the minimal air volume that triggered RAIR (r=-0.01, p=0.94). The mean value ±SD of the transverse diameter of the rectum in patients with functional constipation was 39±14 mm, and in children without constipation 26±6 mm (p<0.05). The mean duration of the symptoms in children with functional constipation was 2.8 years. Conclusions. There were no correlations between the volume of air that induced the RAIR and the transverse diameter of the rectum in children with functional constipation. The transverse diameter of the rectum was increased in children with long-term functional constipation.

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Inability of the Rome III Criteria to Distinguish Functional Constipation From Constipation-Subtype Irritable Bowel Syndrome

The American Journal of Gastroenterology ◽

10.1038/ajg.2010.200 ◽

2010 ◽

Vol 105 (10) ◽

pp. 2228-2234 ◽

Cited By ~ 127

Author(s):

Reuben K Wong ◽

Olafur S Palsson ◽

Marsha J Turner ◽

Rona L Levy ◽

Andrew D Feld ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Functional Constipation ◽

Rome Iii Criteria ◽

Rome Iii ◽

Irritable Bowel

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INFLUENCE OF DRINKING A PROBIOTIC FERMENTED MILK BEVERAGE CONTAINING BIFIDOBACTERIUM ANIMALIS ON THE SYMPTOMS OF CONSTIPATION

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201700000-27 ◽

2017 ◽

Vol 54 (3) ◽

pp. 206-210 ◽

Cited By ~ 5

Author(s):

Thaís Rodrigues MOREIRA ◽

Daiane LEONHARDT ◽

Simara Rufatto CONDE

Keyword(s):

Bowel Movement ◽

Intervention Group ◽

Fermented Milk ◽

Wilcoxon Test ◽

Control Group ◽

Rome Iii Criteria ◽

Post Intervention ◽

Bifidobacterium Animalis ◽

Incomplete Evacuation ◽

Rome Iii

ABSTRACT BACKGROUND Constipation is a chronic problem in many patients all over the world. OBJECTIVE - To evaluate the effect of consumption of a probiotic fermented milk beverage containing Bifidobacterium animalis on the symptoms of constipation. METHODS - This randomized, double-blind controlled trial included 49 female patients aged 20 to 50 years and diagnosed with constipation according to the ROME III criteria (Diagnostic Criteria for Functional Gastrointestinal Disorders) and the Bristol Stool Form Scale. The patients were randomized into two groups: the intervention group received the probiotic fermented milk beverage and the control group received non-probiotic milk. Participants were instructed to ingest 150 mL of the beverages during 60 days. At the end of this period, patients were assessed again by the ROME III criteria and Bristol scale. The Wilcoxon test was used to evaluate pre and post-intervention results of the ROME III criteria and Bristol scale. The statistical significance level was considered as 5% ( P ≤0.05). RESULTS - The intervention group showed improvement in the following criteria: straining during a bowel movement ( P <0.001), feeling of incomplete evacuation ( P <0.001) and difficulty in passing stool ( P <0.014), in addition to Bristol scale results ( P <0.001). In the control group, improvements were observed in the following criteria: straining during a bowel movement ( P <0.001), feeling of incomplete evacuation ( P <0.001) and difficulty in passing stool ( P <0.025), in addition to Bristol scale results ( P <0.001). No statistically significant post-intervention differences were observed between the two groups for the Rome III criteria and Bristol scale. CONCLUSION - The results show that the consumption of milk resulted in the improvement of constipation symptoms, regardless of the probiotic culture.

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Use of Rome II versus Rome III criteria for diagnosis of functional constipation in young children

Pediatrics International ◽

10.1111/ped.12194 ◽

2014 ◽

Vol 56 (1) ◽

pp. 83-88 ◽

Cited By ~ 16

Author(s):

Seksit Osatakul ◽

Areeruk Puetpaiboon

Keyword(s):

Young Children ◽

Functional Constipation ◽

Rome Iii Criteria ◽

Rome Iii ◽

Criteria For Diagnosis

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Female Functional Constipation Is Associated with Overactive Bladder Symptoms and Urinary Incontinence

BioMed Research International ◽

10.1155/2017/2138073 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 8

Author(s):

Takahiro Maeda ◽

Masuomi Tomita ◽

Atsushi Nakazawa ◽

Gen Sakai ◽

Shinsuke Funakoshi ◽

...

Keyword(s):

Urinary Incontinence ◽

Overactive Bladder ◽

Functional Constipation ◽

Cross Sectional Study ◽

Urinary Symptoms ◽

Rome Iii Criteria ◽

Cross Sectional ◽

Associated Factor ◽

Female Patients ◽

Rome Iii

This noninterventional cross-sectional study aims to assess the association between functional constipation (FC) and urinary symptoms in female patients with no treatment for urination and defecation. The Rome III criteria for evaluation of defecation, Overactive Bladder Symptom Score (OABSS) for evaluation of urinary symptoms, and clinical features were investigated in 145 female patients. Latent FC and moderate to severe overactive bladder (OAB) were defined on the basis of positivity for two or more of the Rome III criteria and an OABSS ≥ 6 with OABSS Q3 ≥ 2, respectively. In 60 latent FC patients, the OABSS was higher (5.0 versus 3.2, p=0.001), and concurrent moderate to severe OAB symptoms and OAB with urinary incontinence were more frequent than those in 85 nonlatent FC patients (33.3 versus 10.6%, p=0.001, and 31.7 versus 7.1%, p<0.001). Multivariate analysis demonstrated that moderate to severe OAB symptoms were a significant associated factor of latent FC (odds ratio (OR) = 4.125, p=0.005), while latent FC was the only associated factor of moderate to severe OAB and OAB with urinary incontinence (OR = 4.227, p=0.005 and OR = 4.753, p=0.004). In conclusion, moderate to severe OAB symptoms are correlated with FC. Moreover, FC is related to moderate to severe OAB symptoms and to OAB with urinary incontinence.

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Prolonged anorectal manometry and external anal sphincter electromyography in ambulant human subjects

Digestive Diseases and Sciences ◽

10.1007/bf01540414 ◽

1990 ◽

Vol 35 (5) ◽

pp. 641-648 ◽

Cited By ~ 54

Author(s):

D. Kumar ◽

D. Waldron ◽

N. S. Williams ◽

C. Browning ◽

M. R. E. Hutton ◽

...

Keyword(s):

Anal Sphincter ◽

Anorectal Manometry ◽

External Anal Sphincter ◽

Human Subjects ◽

Sphincter Electromyography

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Some Risk Factors of Chronic Functional Constipation Identified in a Pediatric Population Sample from Romania

Gastroenterology Research and Practice ◽

10.1155/2016/3989721 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Claudia Olaru ◽

Smaranda Diaconescu ◽

Laura Trandafir ◽

Nicoleta Gimiga ◽

Gabriela Stefanescu ◽

...

Keyword(s):

Family History ◽

Dietary Habits ◽

Pediatric Population ◽

Positive Family History ◽

Population Sample ◽

Control Sample ◽

Functional Constipation ◽

Control Group ◽

Significant Difference ◽

History Of

We conducted an observational study over a 1-year period, including 234 children aged 4–18 years and their caregivers and a matching control group. 60.73% of the children from the study group were males. Average age for the onset of constipation was 26.39 months. The frequency of defecation was 1/4.59 days (1/1.13 days in the control group). 38.49% of the patients in the sample group had a positive family history of functional constipation. The majority of children with functional constipation come from single-parent families, are raised by relatives, or come from orphanages. Constipated subjects had their last meal of the day at later hours and consumed fast foods more frequently than the children in the control sample. We found a statistically significant difference between groups regarding obesity/overweight and constipation (χ2=104.94, df=2, p<0.001) and regarding physical activity and constipation (χ2=18.419; df=3; p<0.001). There was a positive correlation between the number of hours spent watching television/using the computer and the occurrence of the disease (F= 92.162,p<0.001, and 95% Cl). Children from broken families, with positive family history, defective dietary habits, obesity and sedentary behavior, are at higher risk to develop chronic functional constipation.

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