Skip Navigation LinksHome > September 2005 - Volume 41 - Issue > COLONIC MANOMETRY IMPROVEMENT AFTER ANTEGRADE COLONIC ENEMAS...
Journal of Pediatric Gastroenterology & Nutrition:
Abstracts: Third European Pediatric GI Motility Meeting: Amsterdam, The Netherlands, September 14-17, 2005

COLONIC MANOMETRY IMPROVEMENT AFTER ANTEGRADE COLONIC ENEMAS VIA CECOSTOMY DOES NOT CORRELATE WITH SUCCESSFUL DISCONTINUATION OF THIS REGIMENNN.

Rodriguez, L; Sabharwal, S; Flores, AF

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Pediatric Neurodigestive Center. *Department of Pediatrics. Floating Hospital for Children. Tufts University School of Medicine

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Background:

Antegrade colonic enemas via cecostomy (ACEC) have been used in a select group of patients with chronic constipation No data is available in relation to its effects on colonic manometry in patients with constipation from colonic neuropathy or Hirschsprung's disease (HD) s/p pull through.

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Objective:

Describe the manometric changes of colonic manometry after ACEC use and its correlation with successful regimennn discontinuation. Methods: 8 patients (2 w/HD) with severe constipation underwent colonic manometry consistent with colonic neuropathy. All 8 patients underwent a cecostomy tube placement and manometry was repeated after a mean of 24 months of ACEC. Parameters evaluated in the colonic manometry: presence of peristaltic contractions during the fasting period, gastrocolonic reflex and bysacodil induced high amplitude peristaltic contractions (HAPC).

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Results:

No patient had gastrocolonic reflex before ACEC, 5 had contractions during the fasting period and 2 had normal HAPC's and 2 other had partially propagated HAPC's. After ACEC 3 patients showed gastrocolonic reflex, all 8 had contractions during fasting period and 4 had normal HAPC's and 4 had partially propagated HAPC's, one patient had normal HAPC's initially that became partially propagated after cecostomy. At a mean follow up of 45 months all patient report significant improvement of their constipation symptoms but all 8 are still depending on the ACEC and multiple attempts to wean its use have failed.

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Conclusions:

Colonic manometry improves after antegrade enemas but it does not correlate with the ability to successfully discontinue their use. This improvement could be attributable to a mechanical effect or an improvement in the contractility of the colon that does seem to have a relationship with the clinical response to ACEC but not with the ability to become independent from them. The parameter that improved the most is the presence of bysacodil induced HAPC's.

© 2005 Lippincott Williams & Wilkins, Inc.

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