Radiopaque markers in children with functional constipation: Potential role in diagnosis, therapy, and outcomes

Area of Science:

• Pediatric Gastroenterology
• Diagnostic Imaging

Background:

• Functional constipation (FC) is a common pediatric condition.
• Accurate diagnosis and management are crucial for improving patient outcomes.

Purpose of the Study:

• To assess the clinical utility of the simplified radiopaque marker (SROM) protocol in diagnosing pediatric functional constipation (FC).
• To evaluate the correlation of SROM findings with patient demographics, symptoms, diagnostic study results, and treatment outcomes.

Main Methods:

• Retrospective analysis of 315 children meeting Rome IV criteria for FC who underwent SROM.
• Comparison of SROM results (marker interpretation, number, distribution) with demographics, symptoms, contrast enema (CE), anorectal manometry (ARM), colon manometry (CM), and therapeutic success (defined by bowel movement frequency and fecal incontinence episodes).

Main Results:

• Abnormal SROM was associated with low BMI Z score and comorbidities (obesity, developmental delay, ADHD, autism).
• SROM correlated with bowel habits and fecal incontinence but did not predict CE or ARM results.
• Concordance with CM was observed in 64% of patients; SROM predicted response to medical therapy but not the need for surgery.

Conclusions:

• SROM is a valuable tool correlating with symptoms, BMI Z score, and comorbidities in pediatric FC.
• SROM can guide the performance of colon manometry and predict response to medical therapy, aiding in escalating treatment strategies.