No role for increased rectal compliance in pediatric functional XXXX .

@entity1 @entity1241 @entity19219 @entity1142
BACKGROUND _ AIMS: Increased rectal compliance has been proposed to contribute to pediatric functional @entity1142 (FC). We evaluated the clinical relevance of increased rectal compliance and assessed whether regular use of enemas improves rectal compliance in @entity1 with FC. METHODS: A prospective longitudinal study was conducted on @entity1 (8-18 years old) with FC. Pressure-controlled rectal distensions were performed at baseline and at 1 year. Rectal compliance was categorized into 3 groups: normal, moderately increased, or severely increased. @entity1 were randomly assigned to groups given conventional therapy or rectal enemas and conventional therapy. Clinical success was defined as >or=3 spontaneous defecations per week and @entity1241 <1 per week. RESULTS: Baseline measurements were performed in 101 @entity1 (11.0 +/- 2.1 years); rectal compliance was normal in 36%, moderately increased in 40%, and severely increased in 24%. @entity1 with severely increased rectal compliance had lower defecation frequency (P = .03), more @entity1241 (P = .04), and more @entity19219 (P < .001). After 1 year, success values were similar between groups: 42% normal, 41% moderately increased, and 40% with severely increased compliance. Barostat studies performed after 1 year in 80 @entity1 (37 conventional therapy and 43 rectal enemas in addition to conventional therapy) revealed that rectal compliance had not changed in either group and had not improved in successfully treated @entity1 . CONCLUSIONS: Constipated @entity1 with severely increased rectal compliance have severe symptoms. However, increased rectal compliance is not related to treatment failure. Regular use of enemas to avoid @entity19219 does not improve rectal compliance in pediatric FC.
