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Characterizing colonic motility in children with chronic intractable constipation: a look beyond high-amplitude
S Wessel1, I J N Koppen1, L Wiklendt2
1Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
Neurogastroenterology and Motility
|February 13, 2016
Summary
Children with chronic intractable constipation have abnormal colonic motor patterns, similar to adults with slow-transit constipation. Their colonic response to meals is impaired, but can be stimulated by bisacodyl.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Physiology
- Motility Disorders
Background:
- Chronic intractable constipation in children presents significant challenges with limited treatment options.
- Understanding colonic motor patterns is crucial for diagnosing and managing pediatric constipation.
Purpose of the Study:
- To characterize colonic motor patterns in children with chronic intractable constipation.
- To compare these patterns with healthy adults and adults with slow-transit constipation.
Main Methods:
- High-resolution water-perfused manometry was used in 18 children with chronic constipation.
- Colonic motor patterns were recorded pre- and post-meal, and after bisacodyl administration.
- Data were compared to healthy adults and adults with slow-transit constipation.
Main Results:
- Children exhibited significantly fewer postprandial retrograde cyclic propagating motor patterns compared to healthy adults.
- Preprandial long-single motor patterns were significantly increased in children versus adults.
- High-amplitude propagating sequences (HAPSs) were rare post-meal but inducible with bisacodyl.
Conclusions:
- Children with chronic intractable constipation display impaired postprandial colonic motor responses, mirroring adults with slow-transit constipation.
- Potential causes include reduced extrinsic parasympathetic input and increased spontaneous long-single motor patterns.
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