Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
You currently have no recent searches
Rodriguez, L; Sabharwal, S; Flores, AF
Pediatric Neurodigestive Center. *Department of Pediatrics. Floating Hospital for Children. Tufts University School of Medicine
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.
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).
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.
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.
Colleague's E-mail is Invalid
Your Name: (optional)
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at Journal of Pediatric Gastroenterology and Nutrition.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.
An Existing Folder
A New Folder
The item(s) has been successfully added to "".
Login with your LWW Journals username and password.
Username or Email:
Enter and submit the email address you registered with. An email with instructions to reset your password will be sent to that address.
Link to reset your password has been sent to specified email address.
What does "Remember me" mean?
By checking this box, you'll stay logged in until you logout. You'll get easier access to your articles, collections,
media, and all your other content, even if you close your browser or shut down your
To protect your most sensitive data and activities (like changing your password),
we'll ask you to re-enter your password when you access these services.
What if I'm on a computer that I share with others?
If you're using a public computer or you share this computer with others, we recommend
that you uncheck the "Remember me" box.
Save my selection
Visit JPGN.org on your smartphone. Scan this code (QR reader app required) with your phone and be taken directly to the site.