Predictive value of colonic transit time indices for differentiating nonnormal from normal sensation in children with chronic functional constipation identified by anorectal manometry.

Children colonic transit constipation manometry predictive value

Journal

Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences
ISSN: 1735-1995
Titre abrégé: J Res Med Sci
Pays: India
ID NLM: 101235599

Informations de publication

Date de publication:
2019
Historique:
received: 27 06 2019
revised: 23 07 2019
accepted: 12 09 2019
entrez: 18 1 2020
pubmed: 18 1 2020
medline: 18 1 2020
Statut: epublish

Résumé

Constipation is a common disorder in pediatrics, although the underlying pathogenesis is not fully understood. The current study aimed at evaluating the efficacy of different colonic transit time (CTT) indices for differentiating normal from nonnormal sensation in children with chronic functional constipation identified by anorectal manometry (ARM). In this cross-sectional study, 47 children with chronic idiopathic constipation, aged 5-15 years, were studied. The total and segmental CTTs were estimated by administering multiple radiopaque markers for 6 days and performing a single abdominal radiograph on day 7. Anorectal function was evaluated using manometry with an Arhan probe. The predictive value of CTT indices was evaluated by receiver operating characteristic curve analysis. Area under the curve (AUC) along with 95% confidence interval (CI) as well as sensitivity and specificity was calculated. The mean age of the participants was 8.30 ± 2.99 years, with a mean constipation duration of 2.90 ± 0.46; 28 children were identified with nonnormal sensation. The mean values of CTT indices were statistically significantly longer in the nonnormal sensation patients than that in the normal group ( CTT is a simple and noninvasive technique for classifying patients with constipation. It can be used for identifying children suffering from chronic constipation with nonnormal sensation reliably, instead of ARM. Colonic inertia may be a manifestation of global motility dysfunction. Children with delayed distal colonic transits are more likely to have abnormal defecation dynamics.

Sections du résumé

BACKGROUND BACKGROUND
Constipation is a common disorder in pediatrics, although the underlying pathogenesis is not fully understood. The current study aimed at evaluating the efficacy of different colonic transit time (CTT) indices for differentiating normal from nonnormal sensation in children with chronic functional constipation identified by anorectal manometry (ARM).
MATERIALS AND METHODS METHODS
In this cross-sectional study, 47 children with chronic idiopathic constipation, aged 5-15 years, were studied. The total and segmental CTTs were estimated by administering multiple radiopaque markers for 6 days and performing a single abdominal radiograph on day 7. Anorectal function was evaluated using manometry with an Arhan probe. The predictive value of CTT indices was evaluated by receiver operating characteristic curve analysis. Area under the curve (AUC) along with 95% confidence interval (CI) as well as sensitivity and specificity was calculated.
RESULTS RESULTS
The mean age of the participants was 8.30 ± 2.99 years, with a mean constipation duration of 2.90 ± 0.46; 28 children were identified with nonnormal sensation. The mean values of CTT indices were statistically significantly longer in the nonnormal sensation patients than that in the normal group (
CONCLUSION CONCLUSIONS
CTT is a simple and noninvasive technique for classifying patients with constipation. It can be used for identifying children suffering from chronic constipation with nonnormal sensation reliably, instead of ARM. Colonic inertia may be a manifestation of global motility dysfunction. Children with delayed distal colonic transits are more likely to have abnormal defecation dynamics.

Identifiants

pubmed: 31949457
doi: 10.4103/jrms.JRMS_460_19
pii: JRMS-24-106
pmc: PMC6950359
doi:

Types de publication

Journal Article

Langues

eng

Pagination

106

Informations de copyright

Copyright: © 2019 Journal of Research in Medical Sciences.

Déclaration de conflit d'intérêts

There are no conflicts of interest.

Références

J Neurogastroenterol Motil. 2017 Oct 30;23(4):561-568
pubmed: 28738452
Am J Gastroenterol. 2010 Apr;105(4):940-5
pubmed: 20197763
Int J Colorectal Dis. 2013 Dec;28(12):1721-4
pubmed: 23887805
Neurogastroenterol Motil. 2002 Oct;14(5):553-9
pubmed: 12358684
J Pediatr (Rio J). 2015 Jul-Aug;91(4):386-91
pubmed: 25986613
Indian J Gastroenterol. 2018 Sep;37(5):385-387
pubmed: 30315493
J Pediatr Gastroenterol Nutr. 2012 Feb;54(2):258-62
pubmed: 21734599
Biometrics. 1988 Sep;44(3):837-45
pubmed: 3203132
J Pediatr Gastroenterol Nutr. 1998 Aug;27(2):138-42
pubmed: 9702642
Neurogastroenterol Motil. 2017 Jan;29(1):null
pubmed: 27723185
Indian J Gastroenterol. 2018 Sep;37(5):410-415
pubmed: 30328091
Int J Colorectal Dis. 2002 Nov;17(6):412-7; discussion 418-9
pubmed: 12355217
Pediatrics. 1992 Jun;89(6 Pt 1):1007-9
pubmed: 1594338
Dis Colon Rectum. 1981 Nov-Dec;24(8):625-9
pubmed: 7318630
J Pediatr Gastroenterol Nutr. 2016 Jun;62(6):847-51
pubmed: 26513617
Gastroenterology Res. 2015 Feb;8(1):157-159
pubmed: 27785288
Braz J Med Biol Res. 2001 Sep;34(9):1147-53
pubmed: 11514838
Pediatr Radiol. 2006 Jan;36(1):43-9
pubmed: 16283286
Colorectal Dis. 2009 Jun;11(5):480-4
pubmed: 18662235
J Pediatr Gastroenterol Nutr. 1996 Oct;23(3):241-51
pubmed: 8890073
J Pediatr Gastroenterol Nutr. 2005 Mar;40(3):273-5
pubmed: 15735478
J Pediatr. 2012 Oct;161(4):615-20.e1
pubmed: 22578584
Pediatr Gastroenterol Hepatol Nutr. 2016 Mar;19(1):38-43
pubmed: 27064388
J Pediatr Gastroenterol Nutr. 2018 Apr;66(4):e89-e98
pubmed: 29287015
Am J Gastroenterol. 2006 Oct;101(10):2401-9
pubmed: 17032205
Arch Dis Child. 1983 Apr;58(4):257-61
pubmed: 6847228
J Pediatr Gastroenterol Nutr. 2014 Feb;58(2):258-74
pubmed: 24345831
J Pediatr Surg. 2004 Feb;39(2):166-9; discussion 166-9
pubmed: 14966733
Arch Dis Child. 2004 Aug;89(8):723-7
pubmed: 15269069
Neurogastroenterol Motil. 2010 Nov;22(11):1164-9
pubmed: 20584262
J Pediatr. 2012 Jul;161(1):44-50.e1-2
pubmed: 22341242
J Pediatr Gastroenterol Nutr. 2002 Jul;35(1):31-8
pubmed: 12142807
Best Pract Res Clin Gastroenterol. 2011 Feb;25(1):3-18
pubmed: 21382575

Auteurs

Maryam Riahinezhad (M)

Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.

Fatemeh Taleb (F)

Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.

Hosein Saneian (H)

Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.

Shadi Kazemi (S)

Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Majid Khademian (M)

Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.

Maryam Farghadani (M)

Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Classifications MeSH