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320 Chapter 16 seven had abnormal findings, including a rectocele in three patients, incomplete relaxation of the puborectalis muscle in one patient and three other patients failed to defecate during the test. High-resolution colonic manometry was performed in six patients, five of these children never had abdominal surgery before and one child had an ileostomy at the time of colonic manometry. Colonic manometry showed abnormal basal and postprandial motor activity of the colon in all patients (manometric details of these patients have been described elsewhere 21 ). Postprandial high amplitude propagating contractions (HAPCs) were identified in one child after the meal (patient 34, Supplemental file 2). These HAPCs were observed to extend over the descending and sigmoid colon, terminating at the top of the rectum. After administration of intraluminal bisacodyl, HAPCs were observed in five of six children. TABLE 1. Patient characteristics No. of patients, n 37 Sex Female, n (%) 25 (68) Median duration of FC symptoms, in months (range) Before first presentation Before surgery 48 (3 – 180) 68 (14 -195) Median age at first appointment in our center, in years (range) 9.1 (1.2 – 16.7) Median age at surgery 12.0 (1.6 – 17.6) Prior pharmacologic treatment Osmotic laxatives Stimulant laxatives Enemas Rectal irrigation 37 (100) 23 (62) 33 (89) 29 (78) Initial surgical intervention Ileostomy Colostomy Subtotal colectomy 21 (57) 10 (27) 6 (16) Requiring 2 procedures Requiring ≥3 procedures 20 (54) 7 (19) No. of patients with anastomosis 6 months after initial surgery 1 year after initial surgery 2 years after initial surgery 13 (35) 17 (46) 19 (51) Co-morbidity History of gastroschisis Behavioral problems a Developmental delay 1 (3) 6 (16) 1 (3) ASD, autism spectrum disorder; ADHD, attention deficit hyperactivity disorder; FC, functional constipation; PDD-NOS, pervasive developmental disorder—not otherwise specified; PTSD, posttraumatic stress disorder; GI, gastrointestinal; UTI, urinary tract infections; GP, general practitioner. a Behavioral problems: n=2 ASD; n=1 ASD and ADHD; n=1 ADHD; n=1 PDD-NOS and PTSD; n=1 anxiety disorder