Meta-analysis: Intestinal ultrasound to evaluate colonic contents and constipation

Area of Science:

• Medical Imaging
• Gastroenterology
• Pediatrics

Background:

• Constipation is clinically diagnosed using Rome criteria.
• Ultrasound (US) offers a non-invasive alternative to X-ray for evaluating colonic contents.
• US lacks the radiation exposure associated with conventional imaging methods.

Purpose of the Study:

• To systematically review and examine the role of ultrasound in assessing constipation.
• To evaluate ultrasound's utility in visualizing colonic contents and identifying constipation indicators.

Main Methods:

• A systematic literature search was conducted across multiple databases (Embase, Medline, Cochrane Central, ClinicalTrials.gov) up to January 2024.
• Studies involving ultrasound assessment of constipation or colonic contents in adults and children were included.
• Meta-analysis was performed on rectal diameter measurements, with risk of bias assessed using established checklists.

Main Results:

• 51 articles, encompassing 6084 patients (3422 children), met the inclusion criteria.
• A significant association was found between rectal diameter and clinical constipation in pediatric studies.
• Meta-analysis revealed a significantly larger mean rectal diameter in constipated patients compared to controls (mean difference 12 mm).
• Additional ultrasound findings included posterior acoustic shadowing and altered echogenicity of luminal contents.

Conclusions:

• Ultrasound is a promising imaging modality for assessing colonic contents and constipation.
• Further rigorous studies are needed to validate ultrasound metrics for accurate constipation identification.