title: Prolonged colonic manometry in children with defecatory disorders.
abstract: OBJECTIVE
  Colonic manometry is a test used in the evaluation of children with defecation disorders unresponsive to conventional treatment. The most commonly reported protocol in pediatrics consists of a study that lasts approximately 4 hours. Given the wide physiological variations in colonic motility throughout the day, longer observation may detect clinically relevant information. The aim of the present study was to compare prolonged colonic manometry studies in children referred for colonic manometry with the more traditional short water-perfused technology.
  
  
  METHODS
  Colonic manometry studies of 19 children (8 boys, mean age 9.4 ± 0.9, range 3.9-16.3) with severe defecation disorders were analyzed. First, a "standard test" was performed with at least 1-hour fasting, 1-hour postprandial, and 1-hour postbisacodyl provocation recording. Afterwards, recordings continued until the next day.
  
  
  RESULTS
  In 2 of the 19 children, prolonged recording gave us extra information. In 1 patient with functional nonretentive fecal incontinence who demonstrated no abnormalities in the short recording, 2 long clusters of high-amplitude contractions were noted in the prolonged study, possibly contributing to the fecal incontinence. In another patient evaluated after failing use of antegrade enemas through a cecostomy, short recordings showed colonic activity only in the most proximal part of the colon, whereas the prolonged study showed normal motility over a larger portion of the colon.
  
  
  CONCLUSIONS
  Prolonged colonic measurement provides more information regarding colonic motor function and allows detection of motor events missed by the standard shorter manometry study.
authors: *Emma Children's Hospital, Amsterdam Medical Center, Amsterdam, The Netherlands †Nationwide Children's Hospital, Columbus, OH ‡Royal Children's Hospital, Brisbane, Australia.
authors: O
authors: O
authors: Liem
authors: R E
authors: RE
authors: Burgers
authors: F L
authors: FL
authors: Connor
authors: M A
authors: MA
authors: Benninga
authors: H M
authors: HM
authors: Mousa
authors: C
authors: C
authors: Di Lorenzo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000503:physiopathology*; D003248:Constipation / Q000503:physiopathology*; D003672:Defecation; D005215:Fasting; D005242:Fecal Incontinence / Q000503:physiopathology*; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008365:Manometry; D019518:Postprandial Period; D012890:Sleep; D013997:Time Factors