CLINICAL-SIGNIFICANCE OF ANISMUS IN ENCOPRESIS

Treatments designed to relieve paradoxical contraction of the anal sph incters during defecation (anismus) have had limited success in childr en with encopresis. This has raised doubts as to the clinical relevanc e of this diagnosis in childhood as anorectal dysfunction. Our aim was to determine whether, in patients who had treatment-resistant encopre sis, the presence of electromyographic anismus was associated with inc reased faecal retention. Sixty-eight children with soiling (mean age 8 .7+/-2.06 years) were assessed by clinical examination, abdominal radi ography and then with anorectal manometry. Patients with electromyogra phic anismus (n=32; 47%) had significantly increased radiographic rect al faecal retention and were significantly less likely to be able to d efecate water-filled balloons. There were no significant differences i n response to prior therapy, history of primary encopresis, behavioura l adjustment or in sociodemographic data. Our results suggest that ele ctromyographic anismus is associated with obstructed defecation and fa ecal retention.