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The role of pelvic floor dysfunction and slow colonic transit in adolescents with refractory constipation.
Am J Gastroenterol 2004; 99(8):1579-84AJ

Abstract

OBJECTIVE

Although pelvic floor dysfunction (PFD) is recognized as a cause of refractory constipation in adults, this diagnosis is not frequently considered in children and adolescents with refractory constipation. The purpose of this study was to examine the symptoms and colonic transit in adolescents with constipation evaluated for a disorder in pelvic floor function.

METHODS

Adolescents with refractory constipation who had undergone anorectal manometry (ARM) and balloon expulsion test (BET) were identified by retrospective review of records. Initial symptoms and the clinician's assessment were used to categorize patients by pediatric Rome II criteria, that is, functional constipation (FC), constipation-predominant irritable bowel syndrome (C-IBS) or functional fecal retention (FFR). Results of scintigraphic colonic transit studies were evaluated. A chi2 test was used to assess the association between individual clinical symptoms and Rome II criteria.

RESULTS

Sixty-seven adolescents underwent evaluation of pelvic floor function by tests for PFD: BET was abnormal in 42%. There was no underlying disease or alternative diagnosis to account for the constipation in these patients. Among the 41 patients who also underwent scintigraphic colonic transit, 30% had slow transit constipation and 12% had both slow colonic transit and abnormal BET. Patients classified as C-IBS were more likely to report weight loss (p = 0.03), bloating (p = 0.04), and incomplete rectal evacuation (p = 0.03).

CONCLUSION

Abnormal pelvic floor function and delayed colonic transit are demonstrable as single or combined problems in adolescents with refractory constipation.

Authors+Show Affiliations

Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.) Program and Department of Pediatrics, Mayo Clinic, Rochester, Minnesota, USA. denesh.chitkara@childrens.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15307880

Citation

Chitkara, Denesh K., et al. "The Role of Pelvic Floor Dysfunction and Slow Colonic Transit in Adolescents With Refractory Constipation." The American Journal of Gastroenterology, vol. 99, no. 8, 2004, pp. 1579-84.
Chitkara DK, Bredenoord AJ, Cremonini F, et al. The role of pelvic floor dysfunction and slow colonic transit in adolescents with refractory constipation. Am J Gastroenterol. 2004;99(8):1579-84.
Chitkara, D. K., Bredenoord, A. J., Cremonini, F., Delgado-Aros, S., Smoot, R. L., El-Youssef, M., ... Camilleri, M. (2004). The role of pelvic floor dysfunction and slow colonic transit in adolescents with refractory constipation. The American Journal of Gastroenterology, 99(8), pp. 1579-84.
Chitkara DK, et al. The Role of Pelvic Floor Dysfunction and Slow Colonic Transit in Adolescents With Refractory Constipation. Am J Gastroenterol. 2004;99(8):1579-84. PubMed PMID: 15307880.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of pelvic floor dysfunction and slow colonic transit in adolescents with refractory constipation. AU - Chitkara,Denesh K, AU - Bredenoord,Albert J, AU - Cremonini,Filippo, AU - Delgado-Aros,Silvia, AU - Smoot,Rory L, AU - El-Youssef,Mounif, AU - Freese,Deborah, AU - Camilleri,Michael, PY - 2004/8/17/pubmed PY - 2004/9/21/medline PY - 2004/8/17/entrez SP - 1579 EP - 84 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 99 IS - 8 N2 - OBJECTIVE: Although pelvic floor dysfunction (PFD) is recognized as a cause of refractory constipation in adults, this diagnosis is not frequently considered in children and adolescents with refractory constipation. The purpose of this study was to examine the symptoms and colonic transit in adolescents with constipation evaluated for a disorder in pelvic floor function. METHODS: Adolescents with refractory constipation who had undergone anorectal manometry (ARM) and balloon expulsion test (BET) were identified by retrospective review of records. Initial symptoms and the clinician's assessment were used to categorize patients by pediatric Rome II criteria, that is, functional constipation (FC), constipation-predominant irritable bowel syndrome (C-IBS) or functional fecal retention (FFR). Results of scintigraphic colonic transit studies were evaluated. A chi2 test was used to assess the association between individual clinical symptoms and Rome II criteria. RESULTS: Sixty-seven adolescents underwent evaluation of pelvic floor function by tests for PFD: BET was abnormal in 42%. There was no underlying disease or alternative diagnosis to account for the constipation in these patients. Among the 41 patients who also underwent scintigraphic colonic transit, 30% had slow transit constipation and 12% had both slow colonic transit and abnormal BET. Patients classified as C-IBS were more likely to report weight loss (p = 0.03), bloating (p = 0.04), and incomplete rectal evacuation (p = 0.03). CONCLUSION: Abnormal pelvic floor function and delayed colonic transit are demonstrable as single or combined problems in adolescents with refractory constipation. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/15307880/The_role_of_pelvic_floor_dysfunction_and_slow_colonic_transit_in_adolescents_with_refractory_constipation_ L2 - http://Insights.ovid.com/pubmed?pmid=15307880 DB - PRIME DP - Unbound Medicine ER -