Contrast enema as a guide for senna-based laxatives in managing overflow retentive stool incontinence in pediatrics

Abstract

Senna-based laxatives are effective treatment for overflow retentive stool incontinence and their doses can be adjusted initially depending on the analysis of the radiological data.

Assessing colonic anatomy normal values based on air contrast enemas in children younger than 6 years

“…Furthermore we wanted to provide ratios compared to a bony structure that would be visible in most images, therefore a vertebral bony structure was deemed most suitable. The use of ratios (comparing colonic size with vertebral body size or with the size of other colonic segments) has been described previously [ 3 , 15 ]. During the first 5 years of life, the spine undergoes a significant growth in size, leading to morphological changes of the vertebrae [ 18 ].…”

“…We used ratios instead of absolute values (e.g., cm or mm) because a ratio enables standardization of the colonic size for age and body size of the child. This method of comparing colon size measurements with bony structures has been described before [ 3 , 15 ]. Moreover, this method did not require an extracorporeal calibration tool such as a ruler or measuring tape, which was not available in the vast majority of the imaging files.…”

“…partial colonic resection) because the dilated or redundant part of the colon is considered dysfunctional [ 7 , 8 , 10 – 13 ]. Furthermore, a recent study has shown that an increased colonic dilation was associated with the need for an increased dose of stimulant laxatives in children [ 3 ]. Therefore findings of colonic dilation and redundancy can have clinical implications.…”

Segmental colonic dilation is associated with premature termination of high‐amplitude propagating contractions in children with intractable functional constipation

“…Segmental colonic dilation is often encountered in children with severe constipation, both of functional and organic origin . In early life, this phenomenon is usually associated with congenital organic diseases such as Hirschsprung's disease, anorectal malformations or other birth defects such as intestinal atresia .…”

“…Segmental colonic dilation is often encountered in children with severe constipation, both of functional and organic origin. [1][2][3][4][5][6][7] In early life, this phenomenon is usually associated with congenital organic diseases such as Hirschsprung's disease, anorectal malformations or other birth defects such as intestinal atresia. [8][9][10][11] However, segmental colonic dilation can also be observed in older children with long-standing symptoms of functional constipation (FC), in whom underlying organic pathology has been ruled out.…”