Related Experiment Video
Updated: Aug 9, 2026
Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice
Published on: July 12, 2018
Colonic manometry as predictor of cecostomy success in children with defecation disorders
Maartje M van den Berg1, Mark Hogan, Donna A Caniano
1Division of Gastroenterology, Department of Pediatrics, The Ohio State University College of Medicine and Public Health, Columbus, OH 43205, USA.
Insights
Colonic manometry effectively predicts cecostomy outcomes in children with defecation disorders. A normal colonic response to bisacodyl indicates a favorable outcome, while generalized colonic dysmotility suggests less benefit from antegrade enemas.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Defecation disorders in children often necessitate surgical intervention like cecostomy.
- Predicting the success of cecostomy is crucial for optimizing patient care and outcomes.
Purpose of the Study:
- To evaluate the predictive value of colonic manometry and contrast enema in children undergoing cecostomy for defecation disorders.
- To identify factors that correlate with successful cecostomy outcomes.
Main Methods:
- Retrospective review of 32 children with defecation disorders who underwent cecostomy.
- Analysis of contrast enema findings for anatomic abnormalities and colonic dilatation.
- Assessment of colonic manometry for high-amplitude propagating contractions (HAPC) and response to bisacodyl.
Main Results:
- 78% of patients achieved successful outcomes post-cecosty.
- Absence of HAPC was linked to unsuccessful outcomes (P = .03).
- A normal colonic response to bisacodyl predicted success (P = .03), while colonic dilatation did not correlate with dysmotility.
Conclusions:
- Colonic manometry is a valuable tool for predicting cecostomy success in pediatric defecation disorders.
- Children with generalized colonic dysmotility may not benefit as much from antegrade enemas via cecostomy.
- A normal colonic response to bisacodyl administration is a positive prognostic indicator for cecostomy outcomes.
Purpose:
The aim of this study was to define the predictive value of colonic manometry and contrast enema before cecostomy placement in children with defecation disorders.
Methods:
Medical records, contrast enema, and colonic manometry studies were reviewed for 32 children with defecation disorders who underwent cecostomy placement between 1999 and 2004. Diagnoses included idiopathic constipation (n = 13), Hirschsprung's disease (n = 2), cerebral palsy (n = 1), imperforate anus (n = 6), spinal abnormality (n = 6), and anal with spinal abnormality (n = 4). Contrast enemas were evaluated for the presence of anatomic abnormalities and the degree of colonic dilatation. Colonic manometry was considered normal when high-amplitude propagating contractions (HAPC) occurred from proximal to distal colon. Clinical success was defined as normal defecation frequency with no or occasional fecal incontinence.
Results:
Colonic manometry was done on 32 and contrast enema on 24 patients before cecostomy. At follow-up, 25 patients (78%) fulfilled the success criteria. Absence of HAPC throughout the colon was related to unsuccessful outcome (P = .03). Colonic response with normal HAPC after bisacodyl administration was predictive of success (P = .03). Presence of colonic dilatation was not associated with colonic dysmotility.
Conclusion:
Colonic manometry is helpful in predicting the outcome after cecostomy. Patients with generalized colonic dysmotility are less likely to benefit from use of antegrade enemas via cecostomy. Normal colonic response to bisacodyl predicts favorable outcome.
Related Concept Videos
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...
01:25Endoscopic Procedures II: Colonoscopy
01:28Endoscopic Procedures III: Video Capsule Endoscopy
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...