Disorders of defecation in children: evaluation and management.

Abstract:

:In a series of 123 children with disorders of defecation, constipation was the main problem in 89 and fecal incontinence in 34. All but three of the latter also had constipation. The principal physical findings were abdominal protuberance with palpable stool in the bowel and the presence of a fecal mass in the rectal ampulla. Laboratory and radiologic findings were nonspecific except in two of the three patients found to have congenital megacolon (Hirschsprung's disease). Rectal suction biopsy, performed in 69 patients, was diagnostic in all three with Hirschsprung's disease. Anorectal manometry, done in 11 patients, was of limited value. In general, treatment consists of patience and understanding on the part of physician and family, a regimen of orally administered (noncathartic) laxatives with dose gradually reduced over weeks to months, frequent telephone communication between physician and parents, and occasional office visits. Patients with nonretentive fecal incontinence require an intensive psychologic approach. A patient, empathetic, and available physician is one of the most important ingredients in the treatment regimen.

journal_name

Postgrad Med

journal_title

Postgraduate medicine

authors

Liebman WM

doi

10.1080/00325481.1979.11715223

subject

Has Abstract

pub_date

1979-08-01 00:00:00

pages

105-8, 110

issue

2

eissn

0032-5481

issn

1941-9260

journal_volume

66

pub_type

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