Colon Transit Time Test in Korean Children with Chronic Functional Constipation

Abstract

Purpose: Each ethnic group has a unique life style, including diets. Life style affects bowel movement. The aim of this study is to describe the results of colon transit time (CTT) tests in Korean children who had chronic functional constipation based on highly refined data.

Methods: One hundred ninety (86 males) out of 415 children who performed a CTT test under the diagnosis of chronic constipation according to Rome III criteria at Konkuk University Medical Center from January 2006 through March 2015 were enrolled in this study. Two hundreds twenty-five children were excluded on the basis of CTT test result, defecation diary, and clinical setting. Shapiro-Wilk and Mann-Whitney U, and chi-square tests were used for statistical analysis.

Results: The median value and interquartile range (IQR) of CTT was 54 (37.5) hours in Encopresis group, and those in non-encopresis group was 40.2 (27.9) hours (p<0.001). The frequency of subtype between non-encopresis group and encopresis was statistically significant (p=0.002). The non-encopresis group (n=154, 81.1%) was divided into normal transit subgroup (n=84, 54.5%; median value and IQR of CTT=26.4 [9.6] hours), outlet obstruction subgroup (n=18, 11.7%; 62.4 [15.6] hours), and slow transit subgroup (n=52, 33.8%; 54.6 [21.0] hours]. The encopresis group (n=36, 18.9%) was divided into normal transit subgroup (n=8, 22.2%; median value and IQR of CTT=32.4 [9.9] hours), outlet obstruction subgroup (n=8, 22.2%; 67.8 [34.8] hours), and slow transit subgroup (n=20, 55.6%; 59.4 [62.7]hours).

Conclusion: This study provided the basic pattern and value of the CTT test in Korean children with chronic constipation.

Keywords: Child; Colon transit; Constipation; Defecation diary; Encopresis; Korea.

Fig. 1. Algorithm to select enrolled patients. Four hundreds fourteen children with constipation were screened on the basis of defecation diary, colon transit time test, and clinical status. Some of the patients were overlaped during screening. Finally, 190 children were enrolled in this study. ^*Acute illness state or patient had better defecation during the colon transit time test than on medication. ^†Puborectalis failure (n=4), imperforate anus (n=1), intracranial hemorrhage (n=1), anticonvulsant medication (n=2), extreme obesity (n=1).

Fig. 2. The distribution of subtypes of colon transit time test. As a whole and in non-encopresis group, normal transit subgroup was the most frequent one. However, in encopresis group, slow transit sugbroup was the most frequent one. The difference in frequency of subtype between non-encopresis group and encopresis was statistically significant (p=0.002). NL: normal transit, OOB: outlet obstruction transit, ST: slow transit.