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Colonic Manometry and Colonic Scintigraphy as a Diagnostic Tool for Children With Severe Constipation

Mugie, Suzanne M.*; Perez, Maria E.; Burgers, Rosa*; Hingsbergen, Elizabeth A.§; Punati, Jaya*; Mousa, Hayat*; Benninga, Marc A.; Lorenzo, Carlo Di*

Journal of Pediatric Gastroenterology & Nutrition: November 2013 - Volume 57 - Issue 5 - p 598–602
doi: 10.1097/MPG.0b013e31829e0bdd
Original Articles: Gastroenterology

Objective: In adults, colonic manometry and colonic scintigraphy are both valuable studies in discriminating normal and abnormal colonic motility. The objective of this study was to compare the diagnostic yield and tolerability of colonic manometry and colonic scintigraphy in children with severe constipation.

Methods: Twenty-six children (mean age 11.4 years, 77% boys) who had received colonic manometry and colonic scintigraphy as part of a colonic motility evaluation were included. Manometry was performed as per department protocol. After swallowing a methacrylate-coated capsule containing indium-111, images were taken at 4, 24, and 48 hours, and geometric centers were calculated. Results of both tests were categorized in 3 groups: normal, abnormal function in the distal part of the colon, and colonic inertia. Cohen κ was used for the level of agreement. Patients and parents completed a questionnaire regarding their experience.

Results: Colonic scintigraphy showed normal transit time in 20%, delay in the distal colon in 48%, and colonic inertia in 32% of patients. Colonic manometry was normal in 40%, abnormal in the distal colon in 40%, and colonic inertia was diagnosed in 20%. The κ score was 0.34. All 5 patients with colonic inertia during manometry had a similar result by scintigraphy. Eighty-eight percent of patients preferred scintigraphy over manometry and 28% of parents preferred colonic manometry over scintigraphy.

Conclusions: Colonic manometry and colonic scintigraphy have a fair agreement regarding the categorization of constipation. Scintigraphy is well tolerated in pediatric patients and may be a useful tool in the evaluation of children with severe constipation.

*Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH

Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands

Division of Pediatric Gastroenterology and Nutrition, Goryeb Children's Hospital, Atlantic Health, Morristown, NJ

§Department of Nuclear Medicine, Nationwide Children's Hospital, Columbus, OH.

Address correspondence and reprint requests to Suzanne M. Mugie, MD, Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Meibergdreef 9, Room C2-312, 1105 AZ Amsterdam, The Netherlands (e-mail:

Received 25 February, 2013

Accepted 23 May, 2013

Drs Mugie and Perez participated equally in this study.

The authors report no conflicts of interest.

© 2013 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,