Faecal soiling and anal achalasia.

Abstract

Effective management of fecal soiling is possible without the specialized equipment needed for manometry or myeoctmy in the diagnosis of anal achalasia. Hirschsprung''s disease is the most usual cause of anal achalasia. Its neurohistology can be established by suction mucosal biopsy from the rectal wall. Empirical stretching of the anus under general anesthesia relieves the symptoms of anal achalasia. In all cases of chronic constipation in children the physical examination and history are confirmed by abdominal radiography. A urine culture is necessary due to the possibility of urinary tract infection. Anal stretching under general anesthesia provides general confirmation and examination for other lesions. Phosphate enema treatment in the hospital is followed by regular stimulation of defecation by bisacodyl until a stable pattern is well established at home.