Department of Pediatrics, Division of Gastroenterology and Nutrition, New York Medical College, Valhalla, NY 10532, USA.
J Pediatr. 2011 Feb;158(2):293-6. doi: 10.1016/j.jpeds.2010.07.063. Epub 2010 Sep 17.
To evaluate the response to rectal distension in children with chronic constipation and children with chronic constipation and encopresis.
We studied 27 children, aged 3 to 16 years, with chronic constipation; 12 had encopresis. Anorectal motility was measured with a solid state catheter. When the catheter was located in the internal sphincter, the balloon was inflated to 60 mL with air.
There were no differences in age, sex distribution, and duration of constipation in the two groups. Comparing groups, anorectal manometry showed no differences in the resting sphincter pressure, recovery pressure, the lowest relaxation pressure, and percent relaxation. However, time to maximum relaxation, time to recovery to baseline pressure, and duration of relaxation were significantly higher in patients with constipation and encopresis, compared with patients who had constipation alone.
There may be an imbalance in neuromuscular control of defecation in constipated patients with encopresis that results in incontinence as a consequence of the increased time to recovery and duration of relaxation of the internal anal sphincter.
评估慢性便秘和慢性便秘伴直肠膨出儿童对直肠扩张的反应。
我们研究了 27 名年龄在 3 至 16 岁之间的慢性便秘儿童，其中 12 名患有直肠膨出。使用固态导管测量肛门直肠动力。当导管位于内括约肌时，用空气将球囊充气至 60 毫升。
两组在年龄、性别分布和便秘持续时间方面无差异。比较两组，肛门直肠测压显示两组在静息括约肌压力、恢复压力、最低松弛压力和松弛百分比方面无差异。然而，在伴有便秘和直肠膨出的患者中，最大松弛时间、恢复到基线压力的时间和松弛持续时间明显高于仅患有便秘的患者。
在伴有直肠膨出的慢性便秘患者中，排便的神经肌肉控制可能存在失衡，导致内肛门括约肌恢复时间和松弛持续时间延长，从而导致失禁。
