title: Colonic manometry via appendicostomy shows reduced frequency, amplitude, and length of propagating sequences in children with slow-transit constipation.
abstract: OBJECTIVE
  We wish to define colonic motor function in children with slow-transit constipation (STC) using manometry catheters introduced through appendiceal stomas, previously sited for controlling fecal retention by colonic irrigation.
  
  
  METHODS
  We undertook 24-hour pancolonic manometry of 6 children (5 boys; mean, 11.5 years; SD, 3.0) using a multilumen silastic catheter.
  
  
  RESULTS
  were compared to nasocolonic motility studies obtained in healthy young adults.
  
  
  RESULTS
  Antegrade propagating sequences (APSs) originated less frequently in the cecum compared to controls. There were fewer APS (mean +/- SEM: STC, 13 +/- 6 per 24 hours; controls, 52 +/- 6 per 24 hours; P < .01) and high-amplitude propagating contractions (HAPCs: STC, 5 +/- 2 per 24 hours; controls, 9.9 +/- 1.4 per 24 hours; P < .05). The amplitude of APS and HAPC was less in STC (APS, 39 +/- 9 mm Hg; controls, 54 +/- 3 per 24 hours; P < .05) (HAPC: STC, 94 +/- 10 mm Hg; control, 117 +/- 3 mm Hg; P < .01), whereas the amplitude of retrograde propagating sequences was greater in STC (43 +/- 6 mm Hg; control, 27 +/- 1 mm Hg; P < .01). The distances propagated by HAPC were significantly less in STC (36 +/- 4.5 vs 47 +/- 2.3 cm, controls; P < .05), and there was no evidence of a region-specific difference in propagation velocity of APS. Neither meal ingestion nor waking significantly increased colonic motor activity in patients with STC.
  
  
  CONCLUSIONS
  Despite the small numbers available to be studied, we found that children with STC in whom an appendicostomy had been placed show significant abnormalities in pancolonic motor function.
authors: Department of Surgical Research, Royal Children's Hospital, Parkville, Victoria 3052, Australia.
authors: Michael P
authors: MP
authors: Stanton
authors: John M
authors: JM
authors: Hutson
authors: Dianne
authors: D
authors: Simpson
authors: Mark R
authors: MR
authors: Oliver
authors: Bridget R
authors: BR
authors: Southwell
authors: Philip
authors: P
authors: Dinning
authors: Ian
authors: I
authors: Cook
authors: Anthony G
authors: AG
authors: Catto-Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D001065:Appendix / Q000601:surgery*; D002404:Catheterization / Q000379:methods; D002648:Child; D003106:Colon / Q000502:physiology*; D003248:Constipation; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D054047:Surgical Stomas