Rectal compliance and rectal sensation in constipated adolescents, recovered adolescents and healthy volunteers
Rectal compliance and rectal sensation in constipated adolescents, recovered adolescents and healthy volunteers
复制标题
便秘青少年、康复青少年和健康志愿者的直肠顺应性和直肠感觉
作者：
M. M. Berg;W. Voskuijl;G. Boeckxstaens;M. Benninga
目的：功能性便秘（FC）的一个亚组的儿童是传统的治疗无效。由于扩张性（顺应性）增加导致的直肠功能异常可能是治疗抵抗性FC的潜在机制。假设FC（RC）成功恢复的患者直肠顺应性正常。研究方法：使用恒压器，在FC患者、至少4年无症状的RC受试者和健康志愿者（HV）中进行压力控制的间歇扩张方案。直肠顺应性的计算采用非线性混合效应模型的体积-压力曲线。结果如下：研究了47例FC患者（中位（范围）年龄为12（11-17）岁）和20例RC受试者（15（11-18）岁），并与22例HV（14（8-16）岁）进行了比较。HV的直肠顺应性中位数（第5 - 95百分位数）为16（12-20）ml/mm Hg。FC患者的直肠顺应性中位数为25（13-47）ml/mm Hg，RC受试者为20（12-35）ml/mm Hg，与HV相比显著更高（p<0.001和p = 0.003）。 与FC患者相比，RC受试者的直肠顺应性较低（p = 0.02）。 45%的RC受试者的直肠顺应性高于正常上限（> HV的第95百分位数），与75%的FC患者相比显著更低（p = 0.02）。 结论：虽然RC受试者的直肠顺应性低于FC青少年，但几乎一半的RC受试者直肠顺应性增加。直肠顺应性在难治性FC中的作用似乎有限，因为尽管直肠顺应性增加，但恢复是可能的。
Objectives: A subgroup of children with functional constipation (FC) are unresponsive to conventional treatment. Abnormal rectal function due to increased distensibility (compliance) might be an underlying mechanism of therapy-resistant FC. It is hypothesised that rectal compliance is normal in patients who are successfully recovered from FC (RC). Methods: Using a barostat, a pressure-controlled intermittent distension protocol was performed in FC patients, RC subjects free of symptoms for at least 4 years and healthy volunteers (HVs). Rectal compliance was calculated using a non-linear mixed-effect model for volume–pressure curves. Results: Forty-seven FC patients, median (range) age of 12 (11–17) years, and 20 RC subjects, 15 (11–18) years, were studied and compared with 22 HVs, 14 (8–16) years. The median (5th–95th percentile) rectal compliance in HVs was 16 (12–20) ml/mm Hg. FC patients had a median rectal compliance of 25 (13–47) ml/mm Hg and RC subjects 20 (12–35) ml/mm Hg, which was significantly higher compared with HVs (p<0.001 and p = 0.003). RC subjects had lower rectal compliance when compared with FC patients (p = 0.02). Forty-five percent of RC subjects had a rectal compliance above the upper limit of normal (>95th percentile of HVs), which was significantly less compared with 75% of FC patients (p = 0.02). Conclusion: While rectal compliance in RC subjects is lower when compared with adolescents with FC, almost half of the RC subjects showed an increased rectal compliance. The role of rectal compliance in therapy-resistant FC seems limited, because recovery is possible despite an increased rectal compliance.
登录
查看更多内容
影响因子：
29.4
作者：
Metcalf, Amanda M.;Phillips, Sidney F.;Wolff, Bruce G.
通讯作者：
Wolff, Bruce G.
DOI：
10.1097/00005176-198711000-00016
发表时间：
1987
影响因子：
2.9
作者：
Loening-Baucke,VA
通讯作者：
Loening-Baucke,VA
气球排便作为功能性便秘和大便失禁儿童预后的预测因子。
DOI：
10.1016/s0022-3476(96)70277-9
发表时间：
1996
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Loening-Baucke,V
通讯作者：
Loening-Baucke,V
肛门直肠生理学和病理生理学。
DOI：
--
发表时间：
1987
期刊：
The American journal of gastroenterology
影响因子：
--
作者：
Whitehead,WE;Schuster,MM
通讯作者：
Schuster,MM
影响因子：
1.9
作者：
LINDSTROM, MJ;BATES, DM
通讯作者：
BATES, DM