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. 2024 Jun 25;11(7):768.
doi: 10.3390/children11070768.

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

Lev Dorfman  1 , Khalil El-Chammas  1   2 , Azadvir Singh  1 , Lin Fei  3 , Sherief Mansi  1   2 , Neha R Santucci  1   2 , Ajay Kaul  1   2
Affiliations

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

Lev Dorfman et al. Children (Basel). .

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; constipation; motility; pediatric; refractory constipation; sacral nerve stimulation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Colonic manometry protocol. Created with BioRender.com.
Figure 2
Figure 2
(A) Abnormal colonic manometry in an 11-year-old male, showing termination of high amplitude propagating contractions in the distal (left) colon. (B) Normal colonic manometry in a 10-year-old female with high amplitude propagating contractions throughout the colon.
Figure 2
Figure 2
(A) Abnormal colonic manometry in an 11-year-old male, showing termination of high amplitude propagating contractions in the distal (left) colon. (B) Normal colonic manometry in a 10-year-old female with high amplitude propagating contractions throughout the colon.
Figure 3
Figure 3
Effect of SNS on constipation in pediatric children with idiopathic constipation. *—statistically significant difference (p < 0.05).
See this image and copyright information in PMC

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