Rectal diameter measured by transabdominal ultrasonography for monitoring treatment response in children with functional constipation
Abstract
BACKGROUND: Transabdominal ultrasonography (USG) is a noninvasive tool for detecting fecal impaction in children with functional constipation (FC) and may predict treatment response. However, supporting evidence remains limited and controversial.
AIM: To evaluate changes in rectal diameter (RD) and anterior rectal wall thickness (AWT) measured by USG in children with FC after treatment with polyethylene glycol (PEG) for 8 weeks.
METHODS: This substudy of a randomized controlled trial included children aged 6 months to 18 years diagnosed with FC according to the Rome IV criteria at King Chulalongkorn Memorial Hospital (May 2024-February 2025). Participants received either commercial PEG or PEG-Chula as laxatives for FC. USG was performed at baseline and at 1, 4, and 8 weeks by the primary investigator. RD and AWT were measured following Klijn’s technique.
RESULTS: Of the 52 enrolled children, 44 completed all four visits. The median age was 50.5 [interquartile range (IQR): 28-92.5] months, and 65.9% were female. The median FC duration was 19.5 (IQR: 12-36) months. Stool frequency and consistency improved significantly over 8 weeks, with no difference between the commercial PEG and PEG-Chula groups. The mean RD decreased significantly from 2.70 cm (95%CI: 2.51-2.88) at baseline to 2.46 cm (95%CI: 2.30-2.62) at week 1, 2.45 cm (95%CI: 2.30–2.60) at week 4, and 2.33 cm (95%CI: 2.18-2.48) at week 8. AWT remained 0.29 cm (95%CI: 0.27–0.32) at baseline and 0.29 cm (95%CI: 0.26–0.30) at week 8 (P = 0.997). The time since the last defecation to USG significantly influenced RD (P = 0.030) but not AWT (P = 0.382).
CONCLUSION: USG-measured RD decreases significantly with effective PEG treatment and may serve as a useful noninvasive marker for monitoring treatment response in children with FC.
Related
- Efficacy of laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair in the treatment of bilateral inguinal hernia: a systematic review and meta-analysis
- Functional near-infrared spectroscopy as a tool for monitoring treatment-related neurofunctional changes in posttraumatic stress disorder and trauma-related symptomatology: a narrative review.
- Primitive reflex profiles and sensorimotor intervention in children with functional constipation and fecal retention
- Nursing interventions for pediatric functional constipation: a systematic review of evidence and clinical implications
- Effectiveness of acupressure foot mats in older adults with functional constipation: protocol for a randomized controlled trial
BibTeX
@article{tran2026rectal,
title = {{Rectal diameter measured by transabdominal ultrasonography for monitoring treatment response in children with functional constipation}},
author = {Duc Long Tran and Nitikarn Pinyoying and Palittiya Sintusek},
journal = {World Journal of Clinical Pediatrics},
year = {2026},
month = nov,
doi = {10.5409/wjcp.119251},
url = {https://doi.org/10.5409/wjcp.119251},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Rectal diameter measured by transabdominal ultrasonography for monitoring treatment response in children with functional constipation
AU - Duc Long Tran
AU - Nitikarn Pinyoying
AU - Palittiya Sintusek
PY - 2026
DA - 2026/11/03
JO - World Journal of Clinical Pediatrics
DO - 10.5409/wjcp.119251
UR - https://doi.org/10.5409/wjcp.119251
AB - BACKGROUND: Transabdominal ultrasonography (USG) is a noninvasive tool for detecting fecal impaction in children with functional constipation (FC) and may predict treatment response. However, supporting evidence remains limited and controversial. AIM: To evaluate changes in rectal diameter (RD) and anterior rectal wall thickness (AWT) measured by USG in children with FC after treatment with polyethylene glycol (PEG) for 8 weeks. METHODS: This substudy of a randomized controlled trial included children aged 6 months to 18 years diagnosed with FC according to the Rome IV criteria at King Chulalongkorn Memorial Hospital (May 2024-February 2025). Participants received either commercial PEG or PEG-Chula as laxatives for FC. USG was performed at baseline and at 1, 4, and 8 weeks by the primary investigator. RD and AWT were measured following Klijn’s technique. RESULTS: Of the 52 enrolled children, 44 completed all four visits. The median age was 50.5 [interquartile range (IQR): 28-92.5] months, and 65.9% were female. The median FC duration was 19.5 (IQR: 12-36) months. Stool frequency and consistency improved significantly over 8 weeks, with no difference between the commercial PEG and PEG-Chula groups. The mean RD decreased significantly from 2.70 cm (95%CI: 2.51-2.88) at baseline to 2.46 cm (95%CI: 2.30-2.62) at week 1, 2.45 cm (95%CI: 2.30–2.60) at week 4, and 2.33 cm (95%CI: 2.18-2.48) at week 8. AWT remained 0.29 cm (95%CI: 0.27–0.32) at baseline and 0.29 cm (95%CI: 0.26–0.30) at week 8 (P = 0.997). The time since the last defecation to USG significantly influenced RD (P = 0.030) but not AWT (P = 0.382). CONCLUSION: USG-measured RD decreases significantly with effective PEG treatment and may serve as a useful noninvasive marker for monitoring treatment response in children with FC.
SN - 2219-2808
ER -