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UvA-DARE ( Digital Academic Repository ) Childhood constipation : new insights in testing , treatment and cost
| Content Provider | Semantic Scholar |
|---|---|
| Author | Mousa Benninga, Marc A. Reddy, S. Narasimha Lorenzo, Carlo Di |
| Copyright Year | 2010 |
| Abstract | Introduction Colonic manometry is a diagnostic test frequently used in the evaluation of children with defecation disorders unresponsive to medical and behavioral management. The standard protocol in pediatrics consists of a study that lasts approximately 4 hours. Given the wide physiologic variations in colonic motility throughout the day, longer observation might detect clinically relevant information. Aim To perform prolonged colonic manometry studies in children referred for colonic manometry in order to compare the information accrued by this system to the more traditional short water perfused technology. Methods A water perfused and a solid state colonic catheter with recording sites positioned at the same level were simultaneously placed using colonoscopy in 19 children (8 boys, mean age 9.4 ± 0.9, range 3.9 – 16.3) presenting with severe defecation disorders. First, a “standard test” was performed with at least 1 hr fasting, 1 hr postprandial and 1 hr post-bisacodyl provocation recording. After this portion of the test was completed, recordings continued until the next day using the solid state, ambulatory technique. Results Colonic manometry was performed in 16 children with intractable constipation, in one child with FNRFI and in two children with symptoms of pseudo-obstruction. Based on the short duration recordings, normal motility in the entire colon was found in 10/19 children. In 4/13 children normal motility was only found in the proximal segment with abnormalities limited to the dilated distal colon. The other children did not show normal motility, ranging from colonic inertia to signs of colonic myopathy. In two of the 19 children prolonged recording gave us information that either could explain their complaints or could have potential implication for therapeutic recommendations. In one patient with FNRFI who demonstrated no abnormalities in the standard short recording, two long clusters of high amplitude contractions were noted in the prolonged study, possibly contributing to the fecal incontinence. In another patient evaluated for partial colectomy after failing cecostomy, standard recordings showed colonic activity only in the most proximal part of the colon while the prolonged study showed normal motility over a larger portion of the colon. Conclusion Prolonged colonic measurement provides more information regarding colonic motor function and allows detection of motor events missed by the standard short manometry study with provocation. Further studies are necessary to evaluate the clinical relevance of this information. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://pure.uva.nl/ws/files/1313199/73020_09.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
