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Abstract
Myectomy of the internal anal sphincter (IAS) has been performed on some children after failure of medical treatment to treat idiopathic constipation. The aim of this study was to compare botulinum toxin injection with myectomy of the IAS in the treatment of chronic idiopathic constipation and soiling in children. This was a double - blind randomized trial. Patients between 1.5 and 11years old were included in the study if they had failed to respond to laxative treatment and anal dilatation for chronic idiopathic constipation. All study patients had anorectal manometry, Ba enema and rectal biopsy. Outcome depended on the improvement of the symptoms of ROME III diagnostic criteria for functional constipation disorders in children