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Updated: Mar 2, 2026
Spatiotemporal Mapping of Motility in Ex Vivo Preparations of the Intestines
Published on: January 27, 2016
Segmental colonic dilation is associated with premature termination of high-amplitude propagating contractions in
I J N Koppen1,2, B P Thompson3, E J Ambeba4
1Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Segmental colonic dilation in children with functional constipation (FC) is linked to impaired colonic motility. This dilation may indicate dysmotility, aiding in diagnosis and treatment strategies for pediatric FC.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
- Pediatric Motility Disorders
Background:
- Intractable functional constipation (FC) in children frequently presents with colonic dilation.
- Understanding the relationship between colonic dilation and motility is crucial for managing pediatric FC.
Purpose of the Study:
- To investigate the association between segmental colonic dilation and colonic dysmotility in children with intractable FC.
- To determine if colonic dilation patterns can serve as indicators of impaired colonic motility.
Main Methods:
- Retrospective analysis of 30 children with intractable FC undergoing colonic manometry and contrast enema.
- Measurement of colonic diameter at 5cm intervals and calculation of standardized colon size (SCS) ratio.
- Assessment of high-amplitude propagating contractions (HAPCs) for colonic motility integrity and correlation with dilation.
Main Results:
- Colonic segments with HAPCs showed significantly smaller diameters than those without (P<.001).
- Children with prematurely terminating HAPCs had larger SCS ratios for colonic diameter than those with fully propagating HAPCs (P=.008).
- SCS ratios for rectosigmoid length, descending colon length, and sigmoid colon diameter were significantly larger in FC patients compared to normative data.
Conclusions:
- Segmental colonic dilation is associated with prematurely terminating HAPCs in children with FC.
- Colonic dilation may serve as a valuable indicator of colonic dysmotility in pediatric functional constipation.
Background:
Colonic dilation is common in children with intractable functional constipation (FC). Our aim was to describe the association between segmental colonic dilation and colonic dysmotility in children with FC.
Methods:
We performed a retrospective study on 30 children with intractable FC (according to the Rome III criteria) who had undergone colonic manometry and contrast enema within a 12-month time period. Colonic diameter was measured at 5 cm intervals from the anal verge up to the splenic flexure. Moreover, the distance between the lateral margins of the pedicles of vertebra L2 was measured to provide a ratio (colonic diameter or length/distance between the lateral margins; "standardized colon size" [SCS]). All manometry recordings were visually inspected for the presence of high-amplitude propagating contractions (HAPCs); a parameter for colonic motility integrity. The intracolonic location of the manometry catheter sensors was assessed using an abdominal X-ray.
Key Results:
Colonic segments with HAPCs had a significantly smaller median diameter than colonic segments without HAPCs (4.08 cm vs 5.48 cm, P<.001; SCS 1.14 vs 1.66, P=.001). Children with prematurely terminating HAPCs had significantly larger SCS ratios for colonic diameter than children with fully propagating HAPCs (P=.008). SCS ratios for the length of the rectosigmoid and the descending colon and the SCS ratio for sigmoid colon diameter were significantly larger in children with FC compared to a previously described normative population (P<.0001, P<.0001 and P=.0007 respectively).
Conclusions & Inferences:
Segmental colonic dilation was associated with prematurely terminating HAPCs and may be a useful indicator of colonic dysmotility.
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