Clinical and diagnostic features of bowel emptying disorders in children, taking into account proctogenic pain against the background of acquired pathology of the anal canal and rectum and their treatment
DOI:
https://doi.org/10.15574/SP.2026.1(153).103118Keywords:
children, constipation, proctitis, hemorrhoids, anal fissure, cryptitis, diagnosis, treatment, preventionAbstract
Aim - is to investigate bowel emptying disorders in children with acquired pathology of the anal canal and rectum, taking into account proctogenic pain, and to substantiate approaches to their comprehensive diagnosis and treatment.
Material and methods. The study included 286 sick children who had bowel emptying disorders against the background of acquired pathology of the anorectal region, which was established during the examination: proctitis in 51 (17.83%), hemorrhoids in 125 (43.71%), anal fissure in 67 (23.43%) and cryptitis in 43 (15.03%). There were 141 boys (49.30%), girls 145 (50.70%).
Results. The studies have established clear age-related characteristics of the incidence with a peak in the group of 4-9 years (28.67%). It was established that bowel emptying disorders in children are manifested by the formation of pathological stereotypes of defecation, in particular, defecation in a diaper (17.48%), feces smearing (15.38%) and defecation in uncomfortable conditions (13.64%), which indicates a significant influence of proctogenic pain. It is proven that proctogenic pain is the leading clinical syndrome and is observed in 85.32% of patients, with intense pain during defecation prevailing (44.75%), and unbearable pain for anal fissure (18.88%) and hidden pain (21.69%). It was found that children develop a negative attitude towards the examination: pronounced negativity towards the examination was noted in 27.27% of cases, towards discussion of constipation - in 20.27%, and smearing - in 13.64%, while adequate perception of the situation is observed only in 17.83% of patients.
Conclusions. Violations of bowel emptying are accompanied by the formation of pathological behavioral stereotypes: emptying into a diaper (17.48%), smearing (15.38%) and defecation in uncomfortable conditions (13.64%). Proctogenic pain is the leading syndrome (85.32%), with a predominance of intense pain (44.75%) and unbearable pain with anal fissure (18.88%), and together with a negative attitude to the examination (27.27%) and discussion of problems (20.27%) forms a vicious circle of “pain - fear - avoidance of defecation - progression of pathology”, which determines the need for a comprehensive approach to treatment. Conservative treatment methods had good results in 98.95%, and surgical treatment was performed in 1.05% patients with hemorrhoids.
The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patients was obtained for conducting the studies.
No conflict of interests was declared by the authors.
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