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Segmental colonic dilation is associated with premature termination of high‐amplitude propagating contractions in children with intractable functional constipation
Author(s) -
Koppen I. J. N.,
Thompson B. P.,
Ambeba E. J.,
Lane V. A.,
Bates D. G.,
Minneci P. C.,
Deans K. J.,
Levitt M. A.,
Wood R. J.,
Benninga M. A.,
Di Lorenzo C.,
Yacob D.
Publication year - 2017
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13110
Subject(s) - medicine , constipation , functional constipation , gastroenterology , splenic flexure , colonoscopy , colorectal cancer , cancer
Abstract Background Colonic dilation is common in children with intractable functional constipation ( FC ). Our aim was to describe the association between segmental colonic dilation and colonic dysmotility in children with FC . Methods We performed a retrospective study on 30 children with intractable FC (according to the Rome III criteria) who had undergone colonic manometry and contrast enema within a 12‐month time period. Colonic diameter was measured at 5 cm intervals from the anal verge up to the splenic flexure. Moreover, the distance between the lateral margins of the pedicles of vertebra L2 was measured to provide a ratio (colonic diameter or length/distance between the lateral margins; “standardized colon size” [ SCS ]). All manometry recordings were visually inspected for the presence of high‐amplitude propagating contractions ( HAPC s); a parameter for colonic motility integrity. The intracolonic location of the manometry catheter sensors was assessed using an abdominal X‐ray. Key Results Colonic segments with HAPC s had a significantly smaller median diameter than colonic segments without HAPC s (4.08 cm vs 5.48 cm, P <.001; SCS 1.14 vs 1.66, P =.001). Children with prematurely terminating HAPC s had significantly larger SCS ratios for colonic diameter than children with fully propagating HAPC s ( P =.008). SCS ratios for the length of the rectosigmoid and the descending colon and the SCS ratio for sigmoid colon diameter were significantly larger in children with FC compared to a previously described normative population ( P <.0001, P <.0001 and P =.0007 respectively). Conclusions & Inferences Segmental colonic dilation was associated with prematurely terminating HAPC s and may be a useful indicator of colonic dysmotility.

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