Related Experiment Videos
Total and segmental colonic transit time and anorectal manometry in children with chronic idiopathic constipation
Carolina Gutiérrez1, Alfredo Marco, Angel Nogales
1Service of Pediatrics and Section of Pediatric Surgery, Hospital General Albacete, Albacete; and Department of Pediatrics, Hospital Universitario Doce de Octubre, Madrid, Spain. cgutiérrez@hgab.insalud.es
Insights
Estimating colonic transit time helps classify pediatric constipation. Some children show delayed transit in specific colon areas, while others have global colonic inertia, indicating motility issues.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Physiology
Background:
- Constipation is common in children, but its causes are often unclear.
- Assessing colonic transit time can differentiate constipation subtypes.
Purpose of the Study:
- To evaluate colonic transit time and anorectal function in children with and without constipation.
- To identify potential physiopathologic mechanisms underlying pediatric constipation.
Main Methods:
- Radiopaque markers were administered to 30 healthy children and 38 with chronic idiopathic constipation (ages 2-14) for 6 days.
- Abdominal radiography on day 7 estimated total and segmental colonic transit times.
- Anorectal manometry assessed function using an Arhan probe.
Main Results:
- Established reference values for colonic transit times (e.g., total colon: 45.7 hours).
- Identified subgroups of constipated children: 50% normal transit, 37% distal delay, 13% colonic inertia.
- Paradoxic anal contraction occurred in 64% of constipated children with distal delay.
Conclusions:
- Colonic transit time measurement is a simple, noninvasive method for classifying pediatric constipation.
- Colonic inertia suggests global motility dysfunction.
- Delayed distal colonic transit correlates with abnormal defecation dynamics.
Background:
Constipation is a frequent symptom in pediatric clinical practice, although the underlying pathogenesis is not fully understood. Estimating the colonic transit time may help identify subgroups of patients with different physiopathologic mechanisms.
Methods:
Thirty children with normal bowel habits and 38 children with chronic idiopathic constipation, aged 2 to 14 years, were studied. The total and segmental colonic transit times were estimated by administering multiple radiopaque markers for 6 days and performing a single abdominal radiograph on day 7. Anorectal function was evaluated using manometry with an Arhan probe.
Results:
The observed upper reference values were 19.02 hours for the right colon, 19 hours for the left colon, 32 hours for the rectosigmoid colon, and 45.7 hours for the total colon. Fifty percent of the children with chronic idiopathic constipation had colonic transit times within reference values, whereas 37% had left colonic and rectosigmoid delays and 13% had global delay in all colonic segments (colonic inertia). Paradoxic anal contraction was observed in 64% of the constipated children with distal delay but in none of the subjects with colonic inertia.
Conclusions:
Estimating colonic transit time is a simple and noninvasive technique for classifying patients with constipation. Colonic inertia may be a manifestation of global motility dysfunction. Children with delayed distal colonic transits are more likely to have abnormal defecation dynamics.