Prospective evaluation of same day versus next day colon manometry results in children with medical refractory constipation.
BACKGROUND
We evaluated the change in colon manometry (CM) parameters and interpretation comparing results when the study is performed the same day after the motility catheter is placed under anesthesia or the following day.


METHODS
CM catheter was placed with colonoscopy under anesthesia and recorded on day 1 and repeated on day 2. Study parameters including motility index during fasting, post-prandial and post-Bisacodyl challenge phase; gastrocolonic response; number, presence and propagation of high amplitude propagating contractions (HAPCs); and, study interpretation were compared between both the days.


RESULTS
Motility index (fasting, post-Bisacodyl phase, P<.05), HAPC number (10.1 vs 6.6, P=.01) and the proportion of patients having HAPCs (92% vs 70%, P=.002) was significantly higher on day 2 vs day 1. HAPC propagation improved on day 2 vs day 1 (fully propagated, 49% vs 37%; partially propagated, 43% vs 33%; absent 8% vs 30%). Study interpretation changed from day 1 to day 2. On day 1, 37% had a normal study and 63% had an abnormal study. On day 2, all patients with a normal study on day 1 remained normal, and patients with an abnormal study on day 1, 53% remained abnormal and 47% had a normal study.


CONCLUSIONS
CM parameters are affected the day the catheter is placed with colonoscopy under anesthesia. The number, presence, and propagation of HAPCs were significantly higher/improved on day 2 compared to day 1. Overall, CM interpretation changed from abnormal to normal from day 1 to day 2 in 47% of the patients.
Center for Motility and Gastrointestinal Functional Disorders, Division of Gastroenterology & Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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http://orcid.org/0000-0003-1118-5066
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Arbizu
Center for Motility and Gastrointestinal Functional Disorders, Division of Gastroenterology & Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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S
Nurko
Center for Motility and Gastrointestinal Functional Disorders, Division of Gastroenterology & Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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N
Heinz
Center for Motility and Gastrointestinal Functional Disorders, Division of Gastroenterology & Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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M
Amicangelo
Center for Motility and Gastrointestinal Functional Disorders, Division of Gastroenterology & Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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L
Rodriguez
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000503:physiopathology*; D003113:Colonoscopy / Q000379:methods / Q000592:standards; D003248:Constipation / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007223:Infant; D008297:Male; D008365:Manometry / Q000379:methods* / Q000592:standards; D011446:Prospective Studies
anesthesia; colon motility; colonic manometry; constipation; pediatrics