Colon transit time in healthy children and adolescents
S Vande Velde1, A Notebaert, V Meersschaut
1Department of Pediatric Gastroenterology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium, saskia.vandevelde@ugent.be.
Insights
Normal colon transit time (CTT) in children is not dependent on age or sex. The Abrahamsson method for measuring CTT is reliable and well-tolerated, showing minimal observer variability.
Area of Science:
- Pediatric Gastroenterology
- Digestive System Physiology
- Radiological Imaging Techniques
Background:
- Accurate measurement of colon transit time (CTT) is crucial for diagnosing pediatric functional gastrointestinal disorders.
- Establishing normative CTT values in healthy children is essential for comparison and interpretation of patient data.
- Variability in CTT measurement methods necessitates evaluation of reliability and observer agreement.
Purpose of the Study:
- To define normal colon transit time (CTT) in healthy children aged 3-18 years.
- To investigate the correlation of CTT with age, Bristol stool scale, and stool frequency.
- To assess the intra- and interobserver variability of the CTT measurement method.
Main Methods:
- A cohort of 54 healthy children (3-18 years) without prior abdominal surgery or medication use was studied.
- Colon transit time (CTT) was measured using radiopaque markers over six days, with a single X-ray on day 7.
- Total and segmental CTT were calculated using the Abrahamsson method (markers x 2.4).
Main Results:
- Median total CTT in healthy children was 36 hours, with no significant age-related differences observed.
- Segmental CTT showed median values of 4.8h (right colon), 2.4h (left colon), and 24h (rectosigmoid).
- A correlation was found between the Bristol stool scale and total CTT (p=0.031), with excellent intra- and interobserver reliability (ICC=0.999).
Conclusions:
- Normal colon transit time (CTT) in children over 3 years is not influenced by sex or age.
- The Abrahamsson method for CTT measurement is practical, well-tolerated, and demonstrates high reliability among observers.
- This study provides a reliable method for assessing CTT in pediatric populations.
Purpose:
The aims of this study are to describe normal colon transit time (CTT) in healthy children, correlate results with age, the Bristol stool scale, and stool frequency, and to evaluate intra- and interobserver variability.
Methods:
Inclusion criteria were as follows: healthy children between 3 and 18 years old with a normal defecation pattern, no history of abdominal surgery, and no medication use. Total and segmental CTT is measured by taking ten polythene radiopaque markers during six consecutive days followed by a single abdominal X-ray on day 7. Total and segmental CTT are calculated by multiplying the number of markers by 2.4 (Abrahamsson et al. Scand J Gastroenterol 32:72-80, 1988).
Results:
Fifty-four children and adolescents have participated: 30 boys and 24 girls (median age 10 years (3-18 years)). Median total CTT is 36 h (<2.4-86.4 h). There is no significant difference for age category (toddlers 31.2 h (<2.4-74.4 h), elementary school 36 h (2.4-79.2 h), and adolescents 43.2 h (14.4-86.4 h)). Segmental CTT reveals a median right colon CTT of 4.8 h (0-28.8 h); a median left colon CTT of 2.4 h (0-31.2 h); and a median rectosigmoidal CTT of 24 h (0-64.8 h). The Bristol stool scale correlates with total CTT (p = 0.031). The intra- and interobserver variability displays an ICC of 0.999 for the total CTT.
Conclusion:
The CTT of normal healthy children is not sex- or age-related (above the age of 3 years). The Abrahamson method for CTT measurement by using bony landmarks for the determination of colon segments is easy to perform and well tolerated with a virtual inexistent rating difference between different observers.
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