RECTAL BIOPSY IN THE INVESTIGATION OF CONSTIPATION

Aims-To develop criteria to prevent unnecessary rectal biopsies in con stipated children. Methods-A retrospective review of 186 rectal biopsi es from 141 children, comparing the age at onset of symptoms with the diagnosis of Hirschsprung's disease. Results-All of the 17 children wi th Hirschsprung's disease had the onset of symptoms before the age of 4 weeks. Twenty seven children had delayed passage of meconium (more t han 48 hours) of whom 10 had Hirschsprung's disease. Three children wi th Hirschsprung's disease were referred after the neonatal period (2 m onths, 11 months, and 3 years) but all had the onset of symptoms befor e 4 weeks of age. Conclusion-If the age at onset of constipation is af ter the neonatal period, a rectal biopsy is unnecessary.