Uloga anorektalne manometrije u predviđanju ishoda liječenja djece s poremećenom defekacijom The role of anorectal manometry in prediction of therapy outcome in children with defecation disorders

摘要

Constipation is a common problem in children. It can be a symptom of functional disorder in majority of cases, but sometimes a serious organic disease is a cause of constipation. Anorectal manometry plays an important role in the diagnostic procedure. It can be presumed that some values of manometric parameters can predict unsatisfactory outcome after conventional treatment of constipation. The aim of this study was to confirm or exclude such limits in manometric finding, to make a plan of the therapy more accurate.ududTherefore the group of 81 constipated children was investigated. There were 58 patients suffering from functional constipation and 23 with organic disorders. The age of the patients was 3 to 15 years. Scoring system was applied to estimate severitiy of constipation and anorectal manometry was performed before and after treatment. Treatment included behaviour and nutritional modification, laxatives and biofeedback training.ududResults of analysis show that most patients expirienced significant benefit from therapy. No manometric finding could predict unsatisfactory outcome, as correlation between most clinical and manometric parameters could indicate. Children with stronger deviation from normal finding in anorectal manometry responded even better to therapy . ududTherefore, the conclusion is that anorectal manometry is important in diagnostic procedure of constipated children, but can not be used to exclude some children from conventional therapy. Scoring system which was not described before was applied, and further investigations are necessary to improve it.ud