Colonic manometry in children with chronic intestinal pseudo-obstruction
C Di Lorenzo1, A F Flores, S N Reddy
1Department of Pediatrics, UCLA Medical Center, Martin Luther King Jr General Hospital, Charles Drew University of Medicine and Science, Torrance 90502.
Gut
|June 1, 1993
Summary
Constipation in children with intestinal pseudo-obstruction is linked to absent high-amplitude propagated contractions (HAPCs) and impaired gastrocolonic response. Colonic manometry is feasible and can identify abnormalities in these pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Colonic Physiology
Background:
- Chronic intestinal pseudo-obstruction (CIPO) is a severe motility disorder in children.
- Constipation is a common and challenging symptom in pediatric CIPO.
- Understanding colonic dysfunction is crucial for managing CIPO.
Purpose of the Study:
- To investigate colonic pressure changes and gastrocolonic response in children with CIPO.
- To determine if colonic manometry can differentiate constipated from non-constipated children with CIPO.
- To identify manometric markers associated with constipation in pediatric CIPO.
Main Methods:
- Colonic manometry was performed in 30 children with CIPO (22 constipated, 8 with upper GI symptoms).
- Intraluminal pressure was recorded in the transverse, descending, and rectosigmoid colon for over four hours.
- A standardized meal was administered to assess the postprandial gastrocolonic response, including motility index and high-amplitude propagated contractions (HAPCs).
Main Results:
- Twenty-four children exhibited colonic contractions; six with hollow visceral myopathy had none.
- Non-constipated children showed a significant increase in motility index and at least one HAPC post-meal.
- Constipated children had a blunted postprandial motility response and lacked HAPCs (p < 0.01).
Conclusions:
- Constipation in pediatric CIPO is associated with absent HAPCs and/or absent gastrocolonic response.
- Colonic manometry is a feasible diagnostic tool in children with CIPO.
- Manometric findings can document specific colonic abnormalities in pediatric CIPO.
Related Concept Videos
01:20Gastrointestinal Motility Disorders
1.6K
Gastrointestinal or GI motility disorders are characterized by irregular gastrointestinal tract movements, disrupting food transit from the mouth to the anus. They are caused by damage or dysfunction in gut muscles or nerves. These disorders can cause symptoms such as severe constipation, diarrhea, abdominal pain, and swallowing difficulties. Disorders can affect any segment of the GI tract and range widely in severity, from common conditions like GERD to life-threatening conditions like...
1.6K
01:25Assessment of the Rectum and Anus
2.1K
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
2.1K
01:21Inflammatory Bowel Disease V: Surgical Management
926
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
926
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
681
This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
681
01:29Intestinal Obstruction I: Introduction
87
Intestinal obstruction is a partial or complete blockage of the small or large intestine that disrupts the normal flow of intestinal contents through the lumen. This interruption impairs digestion, absorption, and fluid balance, and may lead to serious complications if not treated promptly.Mechanical ObstructionMechanical obstruction occurs when a physical blockage prevents intestinal contents from passing, arising from within the lumen or the bowel wall, or from external compression.Adhesions,...
87
01:07Intestinal Obstruction II: Pathophysiology
76
Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
76