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Constipation and ARM

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quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth -

"Constipation is a constant sequela and should be treated aggressively. (This is true also for male patients with perineal fistulas.) We have learned that the lower the defect, the greater the chance of constipation. We have also learned that constipation is a self-perpetuating and self-aggravating condition that eventually produces severe megacolon, chronic faecal impaction, and overflow pseudo-incontinence; it must be vigilantly avoided."

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quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth -

"Constipation is a common sequela seen after the repair of an anorectal malformation. Interestingly, patients with lower defects, and therefore with better prognosis for bowel control, suffer a higher incidence of constipation and vice versa. Constipation correlates directly with the degree of rectosigmoid dilation at the time of colostomy closure. Therefore, every effort should be made to try to keep the rectosigmoid empty and decompressed from day 1 in these patients."

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