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Colonic Volume Changes in Paediatric Constipation Compared to Normal Values Measured Using MRI
Hayfa Sharif1,2, Caroline L Hoad3, Nichola Abrehart1
1Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK.
Insights
Children with functional constipation (FC) have larger colonic volumes than healthy children. This objective measurement of colon size in FC may improve diagnosis and treatment strategies.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Digestive Health
Background:
- Functional constipation (FC) is a common pediatric condition.
- Current management relies on subjective symptom reports.
- Objective data on pediatric colonic volume is scarce, especially in physiological states.
Purpose of the Study:
- To measure undisturbed colonic volumes in children with functional constipation (FC) using magnetic resonance imaging (MRI).
- To establish initial normal range values for colonic volume in healthy children.
- To investigate the correlation between colonic volume and whole gut transit time (WGTT).
Main Methods:
- MRI was used to measure total and regional colon volumes in 35 children (16 with FC, 19 healthy controls) aged 7-18 years.
- Colonic volumes were corrected for body surface area.
- Linear regression analyzed the relationship between total colon volume and WGTT.
Main Results:
- Children with FC exhibited significantly higher total colonic volumes (median 309 mL) compared to healthy controls (median 227 mL).
- The most substantial volume increase in FC patients was observed in the sigmoid colon-rectum region.
- A significant positive correlation was found between total colonic volume and WGTT (R = 0.56, p = 0.0005).
Conclusions:
- This study demonstrates increased physiological colonic volumes in children with functional constipation.
- Objective colonic volume measurement offers valuable insights into FC pathophysiology.
- Findings may aid in refining diagnostic approaches and treatment strategies for pediatric FC.
Background:
Functional constipation in children is common. Management of this condition can be challenging and is often based on symptom reports. Increased, objective knowledge of colonic volume changes in constipation compared to health could provide additional information. However, very little data on paediatric colonic volume is available except from methods that are invasive or require unphysiological colonic preparations.
Objectives:
(1) To measure volumes of the undisturbed colon in children with functional constipation (FC) using magnetic resonance imaging (MRI) and provide initial normal range values for healthy controls, and (2) to investigate possible correlation of colonic volume with whole gut transit time (WGTT).
Methods:
Total and regional (ascending, transverse, descending, sigmoid, and rectum) colon volumes were measured from MRI images of 35 participants aged 7-18 years (16 with FC and 19 healthy controls), and corrected for body surface area. Linear regression was used to explore the relationship between total colon volume and WGTT.
Results:
Total colonic volume was significantly higher, with a median (interquartile range) of 309 mL (243-384 mL) for the FC group than for the healthy controls of 227 mL (180-263 mL). The largest increase between patients and controls was in the sigmoid colon-rectum region. In a linear regression model, there was a positive significant correlation between total colonic volume and WGTT (R = 0.56, p = 0.0005).
Conclusions:
This initial study shows increased volumes of the colon in children with FC, in a physiological state, without use of any bowel preparation. Increased knowledge of colonic morphology may improve understanding of FC in this age group and help to direct treatment.
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