Hirschsprung disease and fecal incontinence: diagnostic and management strategies

Levitt, Marc A.; Martin, Colin; Olesevich, Max; Bauer, Cathy L.; Jackson, Lyndsey; Peña, Alberto

doi:10.1016/j.jpedsurg.2008.10.053

Cited by 84 publications

(57 citation statements)

References 26 publications

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“…22 Clinically, the differentiation between "true" incontinence due to the deficit of anal sphincters or an overflow incontinence resulting from a severe constipation, is therefore essential to obtain a better and more adapted management, but difficult to make. 23 Anorectal manometry is considered an objective way to visualize anorectal function. However, there are few reports about anorectal manometry during follow-up of children operated on for HD, and its role still seems controversial in terms of the uses of different anorectal manometry systems (conventional versus high-resolution anorectal manometry [HRAM]), lack of normal value, particularly the reference value of HRAM in HD patients.…”

Section: Discussionmentioning

confidence: 99%

Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung's Disease

Tran

Mahler

Bontems

et al. 2018

J Neurogastroenterol Motil

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Background/AimsAlthough many advances in the management of Hirschsprung's disease have recently been achieved, postoperative outcomes of these patients remain difficult in a non-negligible number of cases. Therefore, this study aims at investigating characteristics of anorectal manometry and its relationship with postoperative outcomes during long-term follow-up in Hirschsprung patients. MethodsPatients over 4 years of age operated on for Hirschsprung's disease were interviewed to complete detailed questionnaires on bowel function. The patients who consented to undergo an anorectal manometry during follow-up were enrolled in this study. We investigated their clinical characteristics, manometric findings, and their postoperative bowel function. ResultsNineteen patients out of 53 patients (35.8%) were enrolled, 68.4% who were male. Mean age of patients at manometry was 11.3 ± 6.3 years. Twelve out of 19 patients (63.2%) were incontinent. The mean anal resting pressures of incontinent patients were significantly lower than continent patients (47 ± 12 mmHg versus 63 ± 11 mmHg, P < 0.05, t test). Due to neurological impairment, only 11 patients (57.9%) were able to perform a complete manometry. A dyssynergic defecation was found in 4 patients during strain tests. Maximum tolerated volume of the incontinent patients was significantly lower than that of the continent patients (97 ± 67 mL versus 181 ± 74 mL, P < 0.05, t test). ConclusionAnorectal manometry is an objective method providing useful information that could guide a more adapted management in patients with defecation disorders after Hirschsprung's disease operation.

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Section: Discussionmentioning

confidence: 99%

Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung's Disease

Tran

Mahler

Bontems

et al. 2018

J Neurogastroenterol Motil

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“…7,8 Dışkı kontinansının sağlanması için normal anal his, sağlam sfinkter mekanizması ve uygun kolonik motilite gereklidir. 5 Posterior sagittal anorektoplasti ameliyatının yapılmaya başlanmasıyla ARM'li hastalarda gözlenen ameliyat sonrası ana sorun, kolon motilite bozukluğuna bağlı kronik kabızlık ve taşma inkontinansıdır. Gerçek sfinkter yetmezliğine bağlı inkontinans geçmişe göre daha az görülen bir problemdir.…”

Section: Discussionunclassified

“…3 Tuvalet terbiyesi ve bezden kurtulma için beklenen yaş üç olarak kabul edildi. 5 Üç yaşından büyük hastalar değerlendirmeye alındı.…”

Section: Gereç Ve Yöntemlerunclassified

Incontinence Results of Patients with Anorectal Malformation and Their Response to Treatment

Çavuşoğlu¹,

Karaman²,

Afşarlar³

et al. 2013

Turkiye Klinikleri J Med Sci

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“…It is generally known that most patients, initially after the TERPT procedure, will have more frequent stools but that this stabilizes over time [2,3].…”

Section: Introductionmentioning

confidence: 99%

Development of Frequency of Stools over Time in Children with Hirschsprung Disease Posttransanal Endorectal One-Stage Pull-through

et al. 2014

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Hirschsprung disease and fecal incontinence: diagnostic and management strategies

Cited by 84 publications

References 26 publications

Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung's Disease

Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung's Disease

Incontinence Results of Patients with Anorectal Malformation and Their Response to Treatment

Development of Frequency of Stools over Time in Children with Hirschsprung Disease Posttransanal Endorectal One-Stage Pull-through

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