Normal ranges for awake anorectal manometry in healthy children
Research type
Research Study
Full title
Awake high-resolution anorectal manometry (AHRAM) in children: a single-centre study with asymptomatic healthy volunteers to define normal values in children
IRAS ID
283737
Contact name
Eleni Athanasakos
Contact email
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Constipation is when you can’t pass a bowel movement (stool) often or difficulty going, even if you do go often. Constipation can cause straining, bleeding, hard and painful stools, tummy pain and feeling generally unwell. Chronic constipation means the problem is ongoing, and can lasts sometimes for years. Soiling is common in children with constipation - this is when you leak stool without control (‘faecal incontinence’).
Chronic Constipation and Faecal Incontinence (CCFI) in children is common with a worldwide prevalence of up to 29.6%. It is treated conservatively by: laxatives (make stool soft or help you feel the urge), toilet training, clearing out your bowel and having a good diet. The majority of children will feel better after these treatments; however, some patients fail to respond to this and continue with a disabling condition, with poor quality of life. The child then often comes into emergency department or for a specialist appointment which leads to a physical exam or having an x-ray to see how much stool is left in the bowel and how slow it is moving.
But the bowel needs many things to work – such as the bottom muscles, signals for the brain to tell you when you need to go and if your pushing the muscles correctly. One specialised test that can answer these questions is ‘anorectal manometry’ (ARM). ARM uses a small tube to measure how well the back passage is working. This test gives us guidance regarding future management.
ARM results can be difficult to interpret in children because we do not currently know what is normal for them. The Gastrointestinal Physiology Unit at Barts NHS in adults, have published normal data on ARM which has improved the management of their patients with CCFI greatly. Our proposed research aims to do the same with children.
REC name
London - Harrow Research Ethics Committee
REC reference
21/PR/1302
Date of REC Opinion
7 Dec 2021
REC opinion
Further Information Favourable Opinion