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

Background  Severe pediatric slow transit constipation (STC) is commonly due to intrinsic colonic neuromuscular disease. We sought to correlate neuromuscular histological phenotypes in pediatric STC with colonic manometric phenotypes using high‐resolution manometry (HRM). We tested the hypothesis th...

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Bibliographic Details
Published in:Neurogastroenterology and motility 2013-01, Vol.25 (1), p.70-e9
Main Authors: Giorgio, V., Borrelli, O., Smith, V. V., Rampling, D., Köglmeier, J., Shah, N., Thapar, N., Curry, J., Lindley, K. J.
Format: Article
Language:English
Subjects:
Adolescent
biomarkers
Bisacodyl
Cathartics
Child
Child, Preschool
Children
Colon
colonic manometry
Constipation
Constipation - etiology
Constipation - pathology
Female
Gastrointestinal Transit - physiology
Genotype & phenotype
Humans
Immunohistochemistry
Male
Manometry - methods
Mental disorders
Neuromuscular Diseases - complications
Neuromuscular Diseases - diagnosis
Neuropathy
Pediatrics
slow transit constipation
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Summary:Background  Severe pediatric slow transit constipation (STC) is commonly due to intrinsic colonic neuromuscular disease. We sought to correlate neuromuscular histological phenotypes in pediatric STC with colonic manometric phenotypes using high‐resolution manometry (HRM). We tested the hypothesis that failure of motor quiescence (FQ) between bisacodyl‐induced high amplitude propagating sequences (HAPSs) might predict neuromuscular pathology. Methods  Eighteen children (10 males, median age: 7.5 years) with refractory STC underwent stationary colonic HRM before segmental colonic resection. Six age‐matched constipated children with normal colonic transit served as controls. Colonic resection specimens underwent histopathological analysis. Conventional manometric parameters and area under the curve (AUC) during a 1‐min period following bisacodyl‐induced HAPSs [PBAUC1], as measure of FQ, were calculated. Key Results  Numbers of postbisacodyl HAPSs in descending and sigmoid segments were lower in patients than controls (P 
ISSN:1350-1925
1365-2982
DOI:10.1111/nmo.12016