Colonic manometry via appendicostomy shows reduced frequency, amplitude, and length of propagating sequences in children with slow-transit constipation.
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.
Stanton
Michael P
MP
Department of Surgical Research, Royal Children's Hospital, Parkville, Victoria 3052, Australia.
Hutson
John M
JM
Simpson
Dianne
D
Oliver
Mark R
MR
Southwell
Bridget R
BR
Dinning
Philip
P
Cook
Ian
I
Catto-Smith
Anthony G
AG
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