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Does the Oral-Anal Transit Test Correlate with Colonic Manometry Findings in Children with Refractory Constipation?

Dranove Jason, Fleishman Nathan, Reddy Saigopala, Teich Steven,
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 ( Dranove Jason ) - Atrium Health Levine Children’s Hospital Department of Pediatric Gastroenterology, Hepatology and Nutrition
 ( Fleishman Nathan ) - Children’s Mercy Hospital Department of Pediatric Gastroenterology
 ( Reddy Saigopala ) - UNC Gillings School of Global Public Health Department of Public Health
 ( Teich Steven ) - Atrium Health Levine Children’s Hospital Division of Pediatric Surgery

Abstract


Purpose: The Oral-anal Transit Test (OTT) is a simple method of obtaining information about colonic transit. We aim to assess the correlation of OTT with the neuromuscular integrity of the colon determined by colonic manometry (CM).

Methods: All patients who had OTT followed by CM were evaluated. Less than 6 of 24 markers remaining on OTT was considered normal. CM was performed per previously published guidelines. A normal CM was defined as at least one High Amplitude Propagating Contraction progressing from the most proximal sensor through the sigmoid colon.

Results: A total of 34 patients underwent both OTT and CM (44% male, age 4?18 years, mean 11.5 years, 97% functional constipation +/? soiling, Hirschsprung's Disease). Of normal and abnormal OTT patients, 85.7% (6/7) and 18.5% (5/27) respectively had normal CM. When all markers progressed to at least the sigmoid colon, this was 100% predictive against colonic inertia. Greater than 50% of patients with manometric isolated sigmoid dysfunction had markers proximal to the recto-sigmoid.

Conclusion: OTT and CM are both valuable studies that assess different aspects of colonic function. OTT can be used as a screening test to rule out colonic inertia. However, the most proximal extent of remaining markers does not predict the anatomical extent of the manometric abnormality, particularly in isolated sigmoid dysfunction.

키워드

Gastrointestinal dysmotility; Fecal incontinence; Constipation; Colonic inertia; Colonic manometry

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