Significance for prolonged recovery time of recoanal inhibitory reflex in children with constipation

Objective To explore the recovery time (Tr) and associated parameters to demonstrate its association with radiological examination and pathology of specimen.Methods The ARM data were collected from 170 patients during May 2012 to March 2014.There were 26 patients with prolonged recovery time (3 month to 6 years,＜1 year n =13,1 3 year(s),n =4,＞3 years,n =9).And 16 of them were operated.Results The normal recovery time was 3 to 15 seconds (9.17 ± 1.26 s) and the prolonged recovery time ＞15 seconds (19.83 ± 5.54 s,P＜0.05).The time was measured from an onset of inhibition to the point of maximum inhibition (Timax) in patients with prolonged r (P＜0.05).And Timax/Tr in patients with prolonged Tr was larger than that of normal (0.35 ± 0.06 vs 0.42 ± 0.08,P＜0.05).But resting anal pressure and high pressure zone length showed no difference between patients with prolonged Tr and normal children.Furthermore,Timax/ Tr of Hirschsprung' s allied disease was also larger than others in patients with prolonged Tr (0.46 ± 0.09 vs 0.38 ± 0.03,P＜0.05).Conclusions The patients with larger Timax/Tr and prolonged Tr are suggestive of a diagnosis of Hirschsprung' s allied disease.Timax/Tr may demonstrate the development of internal anal sphincter and the establishment of RAIR.Thus it is significant for the diagnosis of constipation. Key words: Constipation;  Rectoanal inhibitory reflex;  Anorectal manometry