A new simplified technique for pediatric anorectal manometry.

Using a new simple technique that is well tolerated and rapid for assessing anal sphincter functions in pediatric patients with fecal incontinence and constipation, 86 patients with varying degrees of anorectal dysfunction were tested. A microtip pressure transducer was used for recording anal sphincter responses to rectal balloon distension. Results were obtained within 15 to 30 minutes. In 17 patients, the internal anal sphincter showed no response or positive spike to balloon distension, consistent with the manometric diagnosis of aganglionic megacolon. These findings were confirmed by absence of ganglion cells on rectal biopsy. Sixty-nine children had normal internal sphincter relaxation to rectal distension. Ganglion cells were present in nine biopsy specimens. In the remaining 60 patients, no further workup of aganglionosis was necessary. There were no false-positive or false-negative results. This technique has proved to be effective for initial evaluation of infants and children with constipation and encopresis.