Gastrointestinal Transit Patterns Identified in Children with Intractable Chronic Constipation using Scintigraphy: Experience of Over 1000 Cases

Hynes, Martin D.; Yik, Yee Ian; Veysey, Duncan; Cook, David J.; Tudball, Coral F.; Hutson, John M.; Southwell, Bridget R.

doi:10.1016/s0016-5085(17)31898-x

Cited by 7 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Delayed gastric emptying has also been documented in children with constipation, functional dyspepsia, and behavioral disorders. As many as 20% of pediatric patients with chronic constipation can have delayed gastric emptying, presumably due to reflexive colonic inhibition of upper gastrointestinal motility . Although data in children are very scarce and there is a lack of standardized diagnostic assessments, about one‐quarter to half of children with functional dyspepsia may have co‐existing delayed gastric emptying .…”

Section: Resultsmentioning

confidence: 99%

Update on pediatric gastroparesis: A review of the published literature and recommendations for future research

Kovacic

Elfar

Rosen

et al. 2019

Neurogastroenterology Motil

View full text Add to dashboard Cite

Background Due to scarcity of scientific literature on pediatric gastroparesis, there is a need to summarize current evidence and identify areas requiring further research. The aim of this study was to provide an evidence‐based review of the available literature on the prevalence, pathogenesis, clinical presentation, diagnosis, treatment, and outcomes of pediatric gastroparesis. Methods A search of the literature was performed using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines with the following databases: PubMed, EMBASE, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, and Web of Science. Two independent reviewers screened abstracts for eligibility. Key Results Our search yielded 1085 original publications, 135 of which met inclusion criteria. Most articles were of retrospective study design. Only 12 randomized controlled trials were identified, all of which were in infants. The prevalence of pediatric gastroparesis is unknown. Gastroparesis may be suspected based on clinical symptoms although these are often non‐specific. The 4‐hour nuclear scintigraphy scan remains gold standard for diagnosis despite lack of pediatric normative comparison data. Therapeutic approaches include dietary modifications, prokinetic drugs, and postpyloric enteral tube feeds. For refractory cases, intrapyloric botulinum toxin and surgical interventions such as gastric electrical stimulation may be warranted. Most interventions still lack rigorous supportive data. Conclusions Diagnosis and treatment of pediatric gastroparesis are challenging due to paucity of published evidence. Larger and more rigorous clinical trials are necessary to improve outcomes.

show abstract

Section: Resultsmentioning

confidence: 99%

Update on pediatric gastroparesis: A review of the published literature and recommendations for future research

Kovacic

Elfar

Rosen

et al. 2019

Neurogastroenterology Motil

View full text Add to dashboard Cite

show abstract

“…1 Yik et al , 18 Bellomo-Brandao et al , 21 Arruda et al , 59 Noviello et al , 60 Mousavi et al . 47 2 Hynes et al , 53 Rawat et al , 48 RBR-7mry33, Kajbafzadeh et al , 43 Ng et al , 42 Gupta et al , 39 Puoti et al , 25 Monjaraz et al , 52 Kuizenga-Wessel et al , 40 Koppen et al , 51 Wessel et al , 44 Campos et al , 24 Nurko et al , 10 RBR-344jq8, Redkar et al , 19 Redkar et al . 36 3 Bonilla et al , 16 Heitmann et al , 23 Gomez-Suarez et al , 37 van Wunnik et al , 35 Haddad et al , 46 Gonzalez et al .…”

Section: Resultsmentioning

confidence: 99%

“…6 Menakaya et al , 55 Zacur et al , 31 Carr et al , 30 Koppen et al , 17 van der Wilt et al , 27 Bellomo-Brandao et al , 50 Valitutti et al . 29 *At least 2 years: Yik et al , 18 Hynes et al ; 53 at least 12 months: Bellomo-Brandao et al , 21 Arruda et al , 59 Rawat et al , 48 RBR-7mry33; at least 6 months: Kajbafzad et al ; 43 at least 3 months: Noviello et al , 60 Gupta et al , 39 Puoti et al , 25 Monjaraz et al , 52 Kuizenga-Wessel et al , 40 Koppen et al , 17 Wessel et al , 44 Mousavi et al , 47 Campos et al , 24 Nurko et al , 10 RBR-344jq8; at least 1 month: Redkar et al , 19 Redkar et al . 36 …”

Section: Resultsmentioning

confidence: 99%

How do we define therapy-resistant constipation in children aged 4–18 years old? A systematic review with meta-narrative synthesis

Sinopoulou,

Gordon,

Rajindrajith

et al. 2024

bmjpo

View full text Add to dashboard Cite

BackgroundTherapy-resistant constipation often is a frustrating clinical entity recognised by the persistence of infrequent and painful bowel movements faecal incontinence and abdominal pain despite intensive treatment. It is important to clearly define therapy-resistant constipation before children are subjected to invasive diagnostic and therapeutic procedures.AimTo conduct a systematic review determining how paediatric interventional studies define therapy-resistant constipation.MethodWe searched CENTRAL, MEDLINE, Embase, WHO ICTR and ClinicalTrials.gov. Studies that included patients with therapy-resistant constipation were identified. Data were extracted on criteria used for defining therapy-resistant constipation and reported using a meta-narrative approach highlighting areas of convergence and divergence in the findings.ResultsA total of 1553 abstracts were screened in duplicate, and 47 studies were included in the review. There were at least seven definitions used in the paediatric literature to define medically resistant constipation. The term intractable was used in 24 articles and 21 used the term refractory to describe therapy-resistant constipation. Out of them, only 14 articles have attempted to provide an explicit definition including a predefined time and prior therapy. There were 10 studies without a clear definition for therapy-resistant constipation. The duration before being diagnosed as therapy-resistant constipation varied from 1 months to 2 years among studies. Seven studies employed the Rome criteria (Rome III or Rome IV) to characterising constipation while five adopted the Rome III and European and North American paediatric societies definition of paediatric gastroenterology, hepatology and nutrition guideline of management of constipation in children.ConclusionThe current literature has no explicit definition for therapy-resistant constipation in children. There is a need for a detailed consensus definition to ensure consistency of future research and to avoid unnecessary and maybe even harmful, invasive diagnostic and therapeutic interventions.

show abstract

“…In fact, colonic transit may be rapid as far as the rectum [ 81 ]. This pattern of “rapid transit constipation” is common in children with chronic constipation, occurring in 29% of 1000 transit studies in one series [ 82 ]. In a group of 55 patients with rapid proximal colonic transit, there was a family history of allergy in 10.9%, and symptoms suggestive of food allergy, including abdominal pain (80%), anal fissure (27.3%) and/or other allergic symptoms (e.g., asthma, eczema) in 43.6%.…”

Section: Introductionmentioning

confidence: 99%

Cows’ Milk Allergy-Associated Constipation: When to Look for It? A Narrative Review

et al. 2022

View full text Add to dashboard Cite

Constipation is a very common disorder, mostly functional in nature, that may persist for years in up to 35–52% of children. Food allergy prevalence, severity and persistence are increasing over time, and cows’ milk protein is the commonest food allergen recognised to affect gastrointestinal motility in children. There is mounting evidence of the role of cows’ milk (CM) allergy (CMA) in children with constipation. With this narrative review, we aim to provide clinicians with an updated and critical overview of food allergy-associated constipation. We searched Embase, Medline and the Cochrane Library, using keywords related to the topic. Only reviews and studies including children aged 0–17 years that were published in English were considered. Constipation has been reported in 4.6% of infants with CMA; the prevalence of food allergy underlying chronic constipation in children resistant to conventional treatment and presenting to tertiary clinics ranges between 28% and 78%. The identification of predisposing risk factors and of a specific phenotype of food allergy-induced constipation remains elusive. No allergic tests or radiological or motility investigations reach a high sensitivity and specificity in screening children for CMA-related constipation. A 4-week cows’ milk protein (CMP) elimination diet may be considered for children with chronic constipation resistant to conventional treatment and who lack alarm sign/symptoms of organic diseases. In subjects with ameliorated symptoms on CMP elimination, the diagnosis of CMA should be confirmed by a food challenge to avoid an unnecessary protracted diet.

show abstract

Gastrointestinal Transit Patterns Identified in Children with Intractable Chronic Constipation using Scintigraphy: Experience of Over 1000 Cases

Cited by 7 publications

References 0 publications

Update on pediatric gastroparesis: A review of the published literature and recommendations for future research

Update on pediatric gastroparesis: A review of the published literature and recommendations for future research

How do we define therapy-resistant constipation in children aged 4–18 years old? A systematic review with meta-narrative synthesis

Cows’ Milk Allergy-Associated Constipation: When to Look for It? A Narrative Review

Contact Info

Product

Resources

About