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Article

Exploring Diagnostic Priorities: The Role of Colonic Manometry in Evaluating Pediatric Patients with Intractable Idiopathic Constipation Prior to Sacral Nerve Stimulation

by
Lev Dorfman
1,
Khalil El-Chammas
1,2,
Azadvir Singh
1,
Lin Fei
3,
Sherief Mansi
1,2,
Neha R. Santucci
1,2 and
Ajay Kaul
1,2,*
1
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
2
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
3
Biostatistics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
*
Author to whom correspondence should be addressed.
Submission received: 23 May 2024 / Revised: 18 June 2024 / Accepted: 21 June 2024 / Published: 25 June 2024
(This article belongs to the Special Issue Advances in Gastrointestinal Surgery in Children)

Abstract

Background: Despite the limited understanding of its precise mechanism of action, sacral nerve stimulation (SNS) has proven to be helpful for pediatric patients with constipation, particularly those with fecal incontinence. It is unclear whether the outcome of SNS is impacted by normal or abnormal colonic motility. Our study aimed to determine whether colonic manometry results had an impact on the outcome of SNS as a treatment in pediatric patients with refractory idiopathic constipation. Methods: Electronic medical records of patients with idiopathic constipation who underwent colonic manometry and SNS placement at our center over 6 years were reviewed. A comparison of post-SNS outcomes was performed between patients with normal and abnormal colonic manometry studies. Results: Twenty patients [12 (60%) females, median age of 10.2 years] met inclusion criteria, with fecal incontinence in 12 (60%) and abnormal colonic manometry in 6 (30%). Significantly more patients had an improvement in fecal incontinence following SNS placement (p = 0.045). There were no significant differences in post-SNS constipation outcome measures between patients with normal versus abnormal colonic manometry. Conclusions: Colonic manometry did not help with patient selection for those being considered for SNS therapy. Our findings do not support performing colonic manometry as a screening prior to SNS placement.
Keywords: colonic manometry; sacral nerve stimulation; constipation; refractory constipation; pediatric; motility colonic manometry; sacral nerve stimulation; constipation; refractory constipation; pediatric; motility

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MDPI and ACS Style

Dorfman, L.; El-Chammas, K.; Singh, A.; Fei, L.; Mansi, S.; Santucci, N.R.; Kaul, A. Exploring Diagnostic Priorities: The Role of Colonic Manometry in Evaluating Pediatric Patients with Intractable Idiopathic Constipation Prior to Sacral Nerve Stimulation. Children 2024, 11, 768. https://0-doi-org.brum.beds.ac.uk/10.3390/children11070768

AMA Style

Dorfman L, El-Chammas K, Singh A, Fei L, Mansi S, Santucci NR, Kaul A. Exploring Diagnostic Priorities: The Role of Colonic Manometry in Evaluating Pediatric Patients with Intractable Idiopathic Constipation Prior to Sacral Nerve Stimulation. Children. 2024; 11(7):768. https://0-doi-org.brum.beds.ac.uk/10.3390/children11070768

Chicago/Turabian Style

Dorfman, Lev, Khalil El-Chammas, Azadvir Singh, Lin Fei, Sherief Mansi, Neha R. Santucci, and Ajay Kaul. 2024. "Exploring Diagnostic Priorities: The Role of Colonic Manometry in Evaluating Pediatric Patients with Intractable Idiopathic Constipation Prior to Sacral Nerve Stimulation" Children 11, no. 7: 768. https://0-doi-org.brum.beds.ac.uk/10.3390/children11070768

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