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Prospective evaluation of same day versus next day colon manometry results in children with medical refractory
R A Arbizu1, S Nurko1, N Heinz1
1Center for Motility and Gastrointestinal Functional Disorders, Division of Gastroenterology & Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Insights
Colon manometry (CM) parameters differ significantly when recorded the day after catheter placement under anesthesia compared to the same day. High-amplitude propagating contractions (HAPCs) were more frequent and better propagated on day 2, altering study interpretations.
Area of Science:
- Gastroenterology
- Physiology
Background:
- Colon manometry (CM) assesses gastrointestinal motility.
- Standard CM procedures involve catheter placement under anesthesia.
Purpose of the Study:
- To compare CM parameters and interpretation between same-day and next-day recordings after catheter placement.
- To determine the impact of anesthesia and catheter dwell time on CM results.
Main Methods:
- CM catheter placed via colonoscopy under anesthesia.
- Recordings performed on Day 1 (same day) and Day 2 (following day).
- Parameters analyzed: motility index, gastrocolonic response, high-amplitude propagating contractions (HAPCs), and study interpretation.
Main Results:
- Motility index and HAPC frequency/propagation were significantly higher on Day 2.
- HAPC propagation improved from Day 1 to Day 2.
- Study interpretation changed in 47% of patients, with some abnormal Day 1 studies becoming normal on Day 2.
Conclusions:
- Anesthesia and catheter placement affect CM parameters.
- Next-day CM recordings (Day 2) show improved HAPC activity and altered interpretations compared to same-day recordings (Day 1).
- Consideration of recording timing is crucial for accurate CM interpretation.
Background:
We evaluated the change in colon manometry (CM) parameters and interpretation comparing results when the study is performed the same day after the motility catheter is placed under anesthesia or the following day.
Methods:
CM catheter was placed with colonoscopy under anesthesia and recorded on day 1 and repeated on day 2. Study parameters including motility index during fasting, post-prandial and post-Bisacodyl challenge phase; gastrocolonic response; number, presence and propagation of high amplitude propagating contractions (HAPCs); and, study interpretation were compared between both the days.
Key Results:
Motility index (fasting, post-Bisacodyl phase, P<.05), HAPC number (10.1 vs 6.6, P=.01) and the proportion of patients having HAPCs (92% vs 70%, P=.002) was significantly higher on day 2 vs day 1. HAPC propagation improved on day 2 vs day 1 (fully propagated, 49% vs 37%; partially propagated, 43% vs 33%; absent 8% vs 30%). Study interpretation changed from day 1 to day 2. On day 1, 37% had a normal study and 63% had an abnormal study. On day 2, all patients with a normal study on day 1 remained normal, and patients with an abnormal study on day 1, 53% remained abnormal and 47% had a normal study.
Conclusions & Inferences:
CM parameters are affected the day the catheter is placed with colonoscopy under anesthesia. The number, presence, and propagation of HAPCs were significantly higher/improved on day 2 compared to day 1. Overall, CM interpretation changed from abnormal to normal from day 1 to day 2 in 47% of the patients.
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