Chronic Pain Abdomen in Children: A Prospective Clinical Study on the Role of Chronic Constipation and Internal Anal Sphincterotomy

Background: Chronic abdominal pain (CAP) in childhood is a frequent and ambiguous problem that poses significant challenges for medical professionals. chronic constipation has been proposed as a significant yet under-recognized etiological factor for CAP. study aims to confirm this by evaluating the relief of CAP following a left lateral internal anal sphincterotomy (LLIAS). Material and Methods: This prospective clinical study was conducted in the Upgraded Department of General Surgery at Osmania Medical College. 23 children aged 0 to 20 years were included in our study. Results: 78.3% of children (18/23) provided a history of constipation, all 23 children achieved 100% relief from abdominal pain by the fourth post-operative day (POD-4). Specifically, 30.4% were pain-free on POD-0 and 21.8% on POD-1. Relief was consistently associated with the passage of large volumes of stools following the surgery. Conclusion: Left lateral internal anal sphincterotomy is an effective and safe procedure for relieving CAP in these children by addressing the underlying anorectal pathology.

Keywords: Chronic abdominal pain, Children, Pediatric constipation, Chronic constipation, Internal anal sphincterotomy, Functional gastrointestinal disorders, Recurrent abdominal pain.