Gulcin Neslihan, Anadolulu Ali Ihsan, Caglar Meltem, Mutus Huseyin Murat, Durakbasa Cigdem Ulukaya
Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye.
North Clin Istanb. 2024 Sep 10;11(5):466-470. doi: 10.14744/nci.2023.85126. eCollection 2024.
The aim was to evaluate the outcomes of conventional anorectal manometry (ARMM) testing and biofeedback therapy in adolescents with functional constipation.
A retrospective analysis of ARMM findings in patients aged 10-18 years with intractable constipation over a 4-year period was conducted.
Of the 41 patients (mean age, 13.5±2.44 years) included, 20 (48.7%) were male. Rectoanal inhibitory reflex (RAIR) was positive in all patients. Group 1 had 31 patients with dyssynergic defecation (DD) and Group 2 had 10 patients without DD. Anal canal resting pressure, squeeze test pressure, rectal defecation pressure, and first and urge sensation volumes were similar between the groups. Maximum tolerated volume and the relaxation percentage of RAIR were higher in Group 1 than in Group 2 (p<0.05). Among 31 patients referred for biofeedback therapy, 8 (25.6%) completed the program with complete resolution of their symptoms. The mean follow-up period for these patients was 21±14.7 months.
DD is relatively common in patients with psychosocial adjustment disorders, and it can be diagnosed via ARMM. Despite the low rate of adherence to the therapy in the presented series, biofeedback therapy was highly effective in resolving the symptoms including soiling.
评估传统肛门直肠测压法（ARMM）检测及生物反馈疗法对功能性便秘青少年患者的治疗效果。
对10至18岁顽固性便秘患者4年期间的ARMM检查结果进行回顾性分析。
纳入的41例患者（平均年龄13.5±2.44岁）中，男性20例（48.7%）。所有患者的直肠肛门抑制反射（RAIR）均为阳性。第1组有31例排便协同失调（DD）患者，第2组有10例无DD患者。两组间肛管静息压、挤压试验压力、直肠排便压力以及首次便意和便意容量相似。第1组的最大耐受容量和RAIR松弛百分比高于第2组（p<0.05）。在接受生物反馈治疗的31例患者中，8例（25.6%）完成治疗且症状完全缓解。这些患者的平均随访期为21±14.7个月。
DD在心理社会适应障碍患者中相对常见，可通过ARMM进行诊断。尽管本系列中治疗依从率较低，但生物反馈疗法在缓解包括污粪在内的症状方面非常有效。
