CURRENT ISSUES IN THE DIAGNOSIS AND TREATMENT OF DOLICHOSIGMA ASSOCIATED WITH CHRONIC CONSTIPATION IN CHILDREN (Literature Review)

Abstract

Impairment of the reservoir and evacuatory function of the large intestine leads to a number of causes that, in turn, may result in various complications. As a consequence, the quality of life of children deteriorates and, in some cases, disability may develop. According to clinical observations, pediatricians and gastroenterologists encounter complaints of chronic constipation and encopresis in 30% or more of cases. According to data from the literature, chronic constipation contributes to behavioral changes in children, intensification of neurotic manifestations, and increased aggressiveness.
According to the findings reported by Malykh A.L. (2011), children with chronic constipation and encopresis demonstrate persistently increased anxiety, heightened emotional sensitivity, and impairments in cognitive functions. Due to chronic endogenous intoxication, delays in physical development and hepatomegaly may also be observed [18].
Chronic constipation is divided into two main types: organic and functional. In most cases, chronic constipation is associated with an increased length of the colon compared to normal, referred to as dolichocolon, or with dilation, known as megadolichocolon. According to various authors, some consider these conditions variants of the norm, while others regard them as pathological. Available data indicate that these conditions account for 9–11% of all colonic anomalies. At the same time, elongation of the sigmoid colon (dolichosigma) is detected in 15% of cases and may itself serve as a contributing factor to constipation.
However, a wide range of nosological entities may be accompanied by chronic constipation, including Hirschsprung’s disease, spina bifida, Payr’s syndrome, and other disorders affecting the motor-evacuatory function of the colon [19].