The use of prostaglandin F2 alpha and scopolamine-N-butylbromide in anorectal manometric diagnosis.

To improve the accuracy of diagnosis of Hirschsprung's disease by means of anorectal manometry, prostaglandin F2 alpha (PGF2 alpha) and scopolamine-N-butylbromide (Buscopan) were used. Normal rectoanal reflex was facilitated by PGF2 alpha in 6 out of 7 children and was abolished or markedly inhibited in 12 out of 13, when Buscopan was given. Obscure rectoanal reflexes in 7 normal neonates were clarified following the administration of PGF2 alpha. On the other hand, atypical rectoanal reflexes observed in 7 children with Hirschsprung's disease were unchanged with either PGF2 alpha or Buscopan. Therefore the use of PGF2 alpha or Buscopan facilitates the manometric diagnosis of Hirschsprung's disease. In 9 postoperative children with Hirschsprung's disease the reflexes were obscure. Five of these 9 reflexes became clear after the administration of PGF2 alpha and 4 remained unchanged. As the normal rectoanal reflex was enhanced by PGF2 alpha, the obscure reflex seen in the postoperative period can be positive or negative, using PGF2 alpha.