Skip Navigation LinksHome > March 2014 - Volume 58 - Issue 3 > Rectal Motility in Pediatric Constipation
Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0000000000000203
Original Articles: Gastroenterology

Rectal Motility in Pediatric Constipation

Moeller Joensson, Iben; Hagstroem, Soren*; Fynne, Lotte; Krogh, Klaus; Siggaard, Charlotte; Djurhuus, Jens C.*

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Objectives: Constipation is a common disorder in children, but little is known about its etiology. Rectal impedance planimetry determines segmental rectal cross-sectional area (CSA) and pressure, allowing detailed description of rectal motility. The aim of the present study was to compare rectal motility in healthy and constipated children.

Methods: We analyzed data from 10 children (1 girl) with constipation according to the Rome III criteria, mean age 8.8 years (standard deviation ± 1.2), and 10 healthy children (5 girls), mean age 9.9 years (standard deviation ± 1.5). CSA was determined at 3 levels (4, 5.5, and 7 cm from the anal verge). The resting rectal motility was recorded for 30 minutes followed by a distension protocol to assess compliance. Runs of phasic rectal contractions were defined as changes of >10% from baseline CSA and lasting at least 2 minutes. Rectal dimensions were expressed as mean CSA.

Results: A low-amplitude contraction pattern (3%–5% of baseline CSA) with a frequency of 6 to 8/minute was present in all of the children. There was significantly more time with phasic rectal contractions in constipated children (median 38%, range [0–100]) compared with healthy children (median 8.8%, range [0–57]) (P < 0.05). The rectal CSA was higher in constipated children (median 1802 mm2 [range 1106–2948]) compared with healthy children (1375 mm2 [range 437–1861]) (P < 0.05), but compliance did not differ (constipated: median 38 mm2/H2O [range 12–86] vs healthy 33 mm2/H2O [range 10–63]) (P = 30).

Conclusions: In children with constipation, we found phasic rectal contractions for a significantly longer period compared with healthy children, and their rectum is larger than normal.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,


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