Gastrointestinal transit in children with chronic idiopathic constipation
- 6 May 2009
- journal article
- research article
- Published by Springer Science and Business Media LLC in Pediatric Surgery International
- Vol. 25 (6), 465-472
- https://doi.org/10.1007/s00383-009-2374-2
Abstract
Chronic constipation in children is common and produces significant morbidity. Identification of the site of dysmotility in constipation may determine the cause and permit directed management. Scintigraphy differentiates constipated patients with anorectal hold-up from those with colonic slowing. Adults with colonic slowing demonstrate variation in the site of hold-up. However, in children with colonic slowing, variability in the site of hold-up has not been investigated. Purpose The current study aimed to characterise colonic transit patterns in 64 children with chronic idiopathic constipation. Methods Scintigraphic images were grouped visually by their transit patterns. Intra-observer variation was assessed. Scintigraphic data were analysed quantitatively. Results Visual analysis of scintigraphy studies demonstrated normal transit (11/64), anorectal hold-up (7/64) and slow colonic transit (46/64). Transit characteristics in the slow transit group demonstrated three possible subgroups: pancolonic slowing (28/46), discrete hold-up in the transverse colon (10/46) and abnormal small and large bowel transit (8/46). Kappa testing demonstrated consistent characterisation (k = 0.79). Statistical analysis of scintigraphic data demonstrated highly significant differences from normal (P < 0.001) in the subgroups. Conclusion Scintigraphy demonstrates three possible transit patterns in children with chronic constipation secondary to slow colonic transit.Keywords
This publication has 56 references indexed in Scilit:
- Radionuclear transit to assess sites of delay in large bowel transit in children with chronic idiopathic constipationJournal of Pediatric Surgery, 2005
- Laparoscopic seromuscular colonic biopsies: a surgeon's experienceJournal of Pediatric Surgery, 2005
- Strategy for the surgical management of patients with idiopathic megarectum and megacolonBritish Journal of Surgery, 2001
- Sensory and autonomic neuropathy in patients with idiopathic slow-transit constipationBritish Journal of Surgery, 1999
- Intractable constipation with a decrease in substance P-immunoreactive fibres: Is it a variant of intestinal neuronal dysplasia?Journal of Pediatric Surgery, 1996
- Reporting simplified colonic transit studies using radionuclides: clinician friendly reports.Gut, 1995
- Radioisotope determination of regional colonic transit in severe constipation.Gut, 1993
- Measurement of colonic transit time using radionuclide imagingNuclear Medicine Communications, 1993
- Measurement of Colonic Transit Time in ChildrenJournal of Pediatric Gastroenterology and Nutrition, 1991
- Neonatal Small Left Colon SyndromeAnnals of Surgery, 1977