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Audit on awake anorectal manometry: tolerability in children
  1. Eleni Athanasakos,
  2. Stewart Cleeve
  1. Paediatric Surgery, Barts Health NHS Trust, London, UK
  1. Correspondence to Dr Eleni Athanasakos, Paediatric Surgery, Barts Health NHS Trust, London E1 1BB, UK; eleni.athanasakos{at}

Statistics from

Chronic constipation (CC) and faecal incontinence (FI) in children is a considerable (0.5%–30% UK and internationally)1 and underappreciated healthcare problem that results in pain, fear of defaecation, embarrassment, poor quality of life2 (patient and family), bullying, school absence and refusal, suicidal ideation and, at worst, suicide attempts.

There is a significant discrepancy regarding the service, particularly investigations, that are offered to children compared with adults.3 Awake anorectal manometry (ARM) is the gold-standard investigation in adult practice, and its use has evolved over the last 25 years. Reasons for this discrepancy are numerous: failure to appreciate the impact, stigma and silent …

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  • Funding This study was funded by Health Foundation Innovating for Improvement (GIFTS 7639 CRM 2656 to set up the service).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed

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