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Colonic transit time--what is normal?
S Wagener1, K R Shankar, R R Turnock
1Alder Hey Children's Hospital, Liverpool England, UK.
Insights
Colonic transit time (CTT) measurement in children provides an objective assessment for constipation. This study establishes normal CTT values in healthy pediatric patients using Abrahamsson's method, aiding in diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Radiology
- Digestive Motility Disorders
Background:
- Childhood constipation is prevalent, with limited data on normal colonic transit time (CTT) in pediatric populations.
- Radiologic methods for investigating constipation in children are varied, but CTT assessment is under-explored.
- Objective measures for evaluating colonic motility in children are scarce.
Purpose of the Study:
- To establish normal colonic transit time (CTT) values in a healthy pediatric cohort.
- To evaluate the utility of Abrahamsson's method for CTT measurement in children.
- To provide reference data for diagnosing pediatric constipation.
Main Methods:
- Colonic transit time (CTT) was measured in 22 healthy children (median age 10 years) using Abrahamsson's method.
- Radiopaque markers were ingested daily for 6 days, followed by an abdominal X-ray on day 7.
- Total and segmental colonic transit times were calculated.
Main Results:
- The mean total CTT was 40 hours, with an upper limit of normal (95th percentile) of 84 hours.
- Normal upper limits for segmental transit times were established: ascending colon (14 hours), transverse colon (33 hours), descending colon (21 hours), and rectosigmoid colon (41 hours).
Conclusions:
- Colonic transit time (CTT) offers an objective method for assessing childhood constipation.
- Abrahamsson's method is well-tolerated, involves low radiation exposure, and provides valuable normal CTT values for children.
- This study contributes essential normative data for pediatric CTT assessment.
Background:
Constipation is a common problem in childhood, and various radiologic methods have been advocated for investigation. Colonic transit time (CTT) has been used in adults to investigate colonic motility, but few studies evaluate this method in children. Data on CTT in the normal paediatric population are scarce.
Methods:
The colonic transit time was measured in 22 healthy children (median age, 10 years; range, 4 to 15 years) by Abrahamsson's method. Children took bolus ingestions of radiopaque markers on 6 consecutive days, and on day 7 a single abdominal x-ray was performed. This was evaluated for total and segmental colonic transit time.
Results:
The mean total CTT was 40 hours, and the upper limit of normal (95th percentile) was 84 hours. The upper limit of normal for segmental transit time was as follows: 14 hours for the ascending, 33 hours for the transverse, 21 hours for the descending, and 41 hours for the rectosigmoid colon.
Conclusions:
CTT provides an objective measure to assess childhood constipation. To date, 6 studies using 5 different methods have been published reporting values for healthy children. Comparing these, Abrahamson's method has low radiation exposure and is well tolerated. This study contributes additional normal values in children.
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