Effect of Caffeine on Colonic Manometry in Children

Abstract

Objectives: Coffee and caffeinated products have been widely consumed for many centuries. Previous adult studies have suggested that both coffee and decaffeinated beverages induce colonic motility. However, no study has been conducted in pediatrics, and the role of caffeine alone in pediatric colonic motility needs to be explored.

Methods: A prospective study of pediatric patients undergoing standard colonic motility testing that were able to consume caffeinated coffee, decaffeinated coffee, and caffeine tablet during colonic manometry. Patients who had a gastrocolonic reflex and high amplitude propagated contractions (HAPCs) in response to intraluminal administration of bisacodyl in the colon were included in the final analyses.

Results: Thirty-eight patients were recruited, 22 of which were excluded, 11 due to abnormal studies (no HAPC seen in response to intraluminal response to bisacodyl), and 11 due to inability to consume all study agents or complete the study. Sixteen patients met criteria for final analyses. Intracolonic bisacodyl produced a larger area under the curve (AUC) compared to all other agents. Caffeinated coffee resulted in a higher AUC, motility index (MI), and time to HAPC compared with decaffeinated coffee ( P < 0.05). There was no significant difference between caffeinated coffee and caffeine tablet, or caffeine tablet and decaffeinated coffee.

Conclusions: Caffeine is indeed a colonic stimulant; however, other components of caffeinated and non-caffeinated beverages likely induce colonic response and require further evaluation for possible use as a colonic stimulant.

FIGURE 1.

Colonic response of all individuals based on AUC (mmHg s) after consumption of each agent. Each line represents an individual and each dot is the response to the respective agent from T = 1 to T = 60 minutes following agent administration/consumption. AUC = area under the curve.

FIGURE 2.

Colonic response to 4 stimulant agents based on HAPC. (A) AUC based on HAPC for each agent. (B) MI based on HAPC for each agent. Bars connecting various agents represent statistical significance as follows: *P < 0.05, **P < 0.01, ***P < 0.001. AUC = area under the curve; HAPC = high amplitude propagated contraction; MI = motility index.

FIGURE 3.

Time to event analysis of 4 stimulant agents that produced HAPC. Time to HAPC for intracolonic bisacodyl was significant versus all other agents (P < 0.001). Time to HAPC for CC versus DC was significant (P < 0.05). CC = caffeinated coffee; DC = decaffeinated coffee; HAPC = high amplitude propagated contraction.