title: Sonographic evaluation of gallbladder motility in children with chronic functional constipation.
abstract: OBJECTIVE
  Studies in adults suggest that constipation may not be a purely colonic pathology and may be a component of a generalized gastrointestinal (GI) motor disorder in which proximal GI motility can be impaired. Pediatric data are scarce, and the natural history of the disorder remains undefined. We aimed to evaluate gallbladder motility in a subset of Asian children with chronic functional constipation.
  
  
  METHODS
  Abdominal ultrasound was performed on 105 children, including 55 patients (aged 3 to 13 years) with chronic functional constipation who met the inclusion criteria and 50 age- and gender-matched controls. The gallbladder contractility index was calculated based on the preprandial and postprandial gallbladder areas. Preprandial and postprandial values for gallbladder volume and wall thickness were evaluated.
  
  
  RESULTS
  The mean value of the contractility index for the patients (15.77±24.68) was significantly lower than the mean value for the controls (43.66±11.58) (p=0.001). The mean postprandial gallbladder volumes and areas were larger in children with gallbladder hypomotility (p<0.05). The mean duration of constipation (4.8 months) was significantly higher (p=0.004) in the children with gallbladder hypomotility.
  
  
  CONCLUSIONS
  Gallbladder motility is significantly impaired in children with chronic functional constipation. This study contributes to the understanding of the underlying pathophysiology, which will enable advancement in and improved management of children with chronic constipation and associated gallbladder hypomotility.
authors.affiliation: Department of Radio Diagnosis, Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Mehra
authors.affiliation: Department of Radio Diagnosis, Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Kushaljit Singh
authors.initials: KS
authors.lastname: Sodhi
authors.affiliation: Department of Postgraduate, Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Akshay
authors.initials: A
authors.lastname: Saxena
authors.affiliation: Department of Gastroenterology, Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: B R
authors.initials: BR
authors.lastname: Thapa
authors.affiliation: Department of Radio Diagnosis, Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003248:Constipation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016473:Gallbladder Emptying / Q000502:physiology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D014463:Ultrasonography
keywords: Children; Constipation; Gallbladder; Motility; Ultrasound