Do Oro‐anal Transit Markers Predict Which Children Would Benefit From Colonic Manometry Studies?

Abstract

OTT studies may be helpful to predict which children should be referred for CM studies. Normal OTT studies may predict normal colon manometry; however, abnormal OTT studies may not predict abnormalities in colonic manometry in children with chronic constipation. Therefore, patients with slow transit marker studies should be assessed by colon manometry to evaluate colon neuromuscular integrity.

High‐resolution colonic manometry accurately predicts colonic neuromuscular pathological phenotype in pediatric slow transit constipation

“…16 However, we believe that the criteria adopted for the purposes of this study were appropriate as they predicted neuromuscular pathology in 17/18 patients and manometric abnormality in 18/18 patients, which appears more sensitive than the retention of >25% of markers 5 days after marker ingestion. 17 Studies of adults with STC using high-resolution methods have demonstrated reduced numbers of HAPS, increased numbers of retrograde LAPS, and absence of the early morning increase in HAPS activity seen around the time of waking. 18,19 In a larger study, Rao et al studied 21 adults with STC using standard 24-h colonic manometry, and they utilized the response to meal ingestion, response to morning waking, and HAPS frequency as diagnostic criteria for classifying the patients as having neuropathy or myopathy.…”

Classification of normal and abnormal colonic motility based on cross‐correlations of pancolonic manometry data

“…Although our technique of cross‐correlation examined the relationship between adjacent channels, it did allocate a greater weight to events that extended through greater lengths of the colon. Our group 5 and others 31 have shown previously in patients with STC, that much of the activity generated in the proximal colon is not transmitted to the distal colon. This is likely to explain why our technique was not as effective when applied to the distal colon only.…”

The magnitude and management of functional constipation at pediatric gastroenterology clinics: A survey study of various countries

“…23 CI is characterized as either delayed colonic transit demonstrated by colonic transit study or absence of gastrocolic response and normal colonic motility responses shown by colonic manometry (CM), after administration of a test meal or bisacodyl. 24,25 Correlation between the results of colonic transit studies and CM was evaluated by two studies, which demonstrated that single ROM capsule (Sitzmarks) ingestion was helpful in screening for CM and that colonic scintigraphy and CM had a fair agreement regarding the categorization of IFC. 24,26 According to our survey, the ROM technique was utilized by the majority of respondents for the initial investigation for CI, followed by CM and colonic scintigraphy.…”