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Radiopaque marker colonic transit study in the pediatric population BSPGHAN Motility Working Group consensus

M Papadopoulos1, M Mutalib1, K Nikaki2

  • 1Department of Paediatric Gastroenterology, Evelina London Children's Hospital, St Thomas' Hospital, London, UK.

Neurogastroenterology and Motility
|March 8, 2024
PubMed

Insights

Functional constipation (FC) in children is common, but the radiopaque marker study (ROMS) for assessing colonic transit time (CTT) lacks standardized protocols. This review aims to provide guidance for consistent ROMS use in pediatric FC diagnosis.

Area of Science:

  • Pediatric Gastroenterology
  • Radiology
  • Clinical Practice Guidelines

Background:

  • Functional constipation (FC) is a prevalent pediatric condition globally.
  • The radiopaque marker study (ROMS) is a standard diagnostic tool for assessing colonic transit time (CTT) in children with FC.
  • Current ROMS protocols exhibit significant variability in methodology and application.

Purpose of the Study:

  • To critically evaluate the existing evidence on ROMS for pediatric FC.
  • To identify inconsistencies in ROMS protocols and their impact on diagnostic accuracy.
  • To develop evidence-based guidance for standardized ROMS implementation in pediatric FC.

Main Methods:

  • Systematic review of literature on ROMS in pediatric functional constipation.
  • Analysis of variations in ROMS protocols, including marker number, study duration, and medication use.
  • Expert consensus development within the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) motility working group (MWG).

Main Results:

  • Identified widespread lack of standardization in ROMS protocols.
  • Highlighted variations in marker dosage, study duration, dietary recommendations, and medication management.
  • Observed inconsistencies in calculation methods and the need for bowel preparation.

Conclusions:

  • Standardization of ROMS is crucial for reliable CTT assessment in pediatric FC.
  • Evidence-based guidelines are needed to address protocol variations and improve diagnostic consistency.
  • Implementing standardized ROMS will enhance the management of functional constipation in children.

Keywords:
colonic manometrycolonic transit time (CTT)constipationpediatricsradiopaque marker study (ROMS)scintigraphy

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