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Objective: To describe the anorectal manometry results in the pediatric population with chronic constipation and acquired anorectal disease., Materials and Methods: We reviewed the records of children who were referred to the Motility and Pelvic Floor Laboratory of the Hospital San Jose Tecnologico de Monterrey between 2004-2016 for further evaluation with anorectal manometry and who presented acquired anorectal disease., Results: We reviewed 170 records. The mean age was 7.18 ± 4.51 years old. The prevalence of anorectal disease was 73%. The symptoms more frequently presented were difficult evacuation (78%), painful defecation (67%), large and hard stool (50%) and fecal soiling (49%). 44% of patients with hypotonic external anal sphincter (EAS) presented with soiling and 74% of those had diminished critical volume. Significant manometric values (p<0.05) were EAS resting pressure, maximal squeeze pressure, and critical volume. 97.7% of those who underwent abdomino pelvic coordination evaluation had pelvic floor dyssynergia (anismus)., Conclusions: Contrary to adult population, the manometric values in children with acquire anorectal pathology were within normal values except for the EAS resting pressure and critical volume that were diminished. This could suggest a different mechanism in the pediatric population. Pelvic floor dyssynergia could explain chronic constipation in these patients.

Introduction: There is a high rate of deliveries in adolescents in Mexico. This age group is vulnerable to obstetric complications, including lacerations of the anal sphincter., Objective: To determine the prevalence of third and fourth degree perineal tears in adolescents during childbirth, and to evaluate risk factors in comparison with deliveries with lacerations of adult women., Methods: All obstetric care episodes were reviewed from a public tertiary hospital data in Monterrey, Mexico in 2014. Age, primiparity, delivery instrumentation, episiotomy, body mass index, product weight and tear´s degree were documented at the deliveries with tears of third and fourth degree., Results: The prevalence of third and fourth degree tears of 2.0% was found in the general population, being adolescents the most affected with 2.5%. The unadjusted odds ratio of high-grade tears in adolescent females at delivery, compared to adult females, was 1.36 (95% CI = 0.99-1.86, p = 0.05). No difference was found when comparing risk factors among high-grade tear deliveries in adolescents versus adults., Conclusions: A higher prevalence than previous reported for high grade tears during delivery was found. The data suggest adolescence as a risk factor for high-grade tears during delivery., Competing Interests: Conflict of interest: nothing

Objective: To determine the frequency of fecal incontinence and the impact on the quality of life of hospitalized geriatric patients in a sample from a level two hospital in Monterrey, Nuevo Leon, Mexico., Materials and Methods: Hospitalized patients over 60 years of age or their caregivers were questioned about the presence of fecal incontinence. Those who responded affirmatively and could respond were given the following questionnaires and scales: Mini-Mental, Rockwood quality of life for fecal incontinence and Wexner scale modified for severity of incontinence; in addition to clinical data. The frequency was calculated based on a sample and associations were determined between degree of incontinence and quality of life., Results: A total of 234 patients were questioned, of whom 135 (57.69%) were women and 99 (42.31%) men. A total of 34 patients with fecal incontinence were documented, this represents a frequency of 14.53% (95% CI, 10.28-19.71%) in this population. A positive correlation of the severity of incontinence was found with the lifestyle dimension (relation (r) = -0.61, p = 0.04), shame (r = -0.70, p = 0.01), behavior (r = -0.73, p = 0.001) and the average of the four dimensions (r = -0.67, p = 0.02) but not with the depression dimension of the quality of life questionnaire in fecal incontinence., Conclusion: When compared with other national and international studies, the frequency of fecal incontinence found was lower than that documented in other series. The quality of life of hospitalized elderly patients with fecal incontinence in this sample was diminished and its impact on quality of life correlated with the severity of fecal incontinence.

Background: Hydrogen breath tests (HBT) are used to confirm the diagnosis of carbohydrate intolerance or small intestinal bacterial overgrowth (SIBO)., Objective: Determine the existence of a correlation between the presence and intensity of symptoms experimented by the patient after the ingestion of a carbohydrate load and the test result., Materials and Methods: This is an observational, retrospective and analytic study, in which all patients' files from year 2008 to 2014 containing a report of a HBT performed at Hospital San José TEC de Monterrey were revised. Using a visual analogue scale (VAS), the patient reported the intensity of gastrointestinal symptoms during the test. Descriptive statistics were obtained, and exclusively for lactose HBTs, Pearson's correlation coefficient (r) between maximum hydrogen concentration in breath and symptom intensity was calculated., Results: A HBT was performed in 33 patients: 23 with lactose, 5 with fructose, and 5 with lactulose as substrate. Of these, 10, 2, and 5 tests were positive, respectively. For lactose HBTs, the symptom with most sensitivity was flatulence (80%), which also had the greatest likelihood ratio for a positive test (1.73). Diarrhea had the greatest specificity (84.6%). A tendency for positivity was observed when patients presented symptoms. A moderately positive correlation between hydrogen ppm and symptom intensity was found (r=0.427, p=0.023)., Conclusions: A correlation between symptom intensity and test positivity was found in patients with lactose intolerance. The presence of flatulence after lactose loading may be indicative of a positive test.