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Colon transit time and anorectal manometry in children and young adults with spina bifida

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Abstract
This study evaluates colon transit time (CTT) and anorectal manometry (ARM) in spina bifida (SB) patients in relation to the level of lesion, mobility, constipation, and continence status. SB patients between 6 and 19 years, who are not using antegrade continence enemas and followed at the SB Reference Centre UZ Ghent, were asked to participate. Medical history was retrospectively retrieved from the medical file. Stool habits were prospectively collected using standardized questionnaires. CTT was measured using the 6-day pellet abdominal X-ray method. ARM was performed in non-sedated children with a water-perfused, latex-free catheter. Forty out of 52 eligible patients consented to perform CTT, of which 19 also performed the ARM. Fifteen (37 %) SB patients were constipated despite treatment. Twenty-six (65 %) were (pseudo) continent. The total CTT was significantly prolonged in SB patients (median CTT 86.4 vs. 36 h controls). The CTT was significantly prolonged in constipated SB patients compared to non-constipated SB patients (122.4 vs. 52.8 h). Spontaneously continent patients had a normal CTT (33.6 h) as well as a significantly higher resting pressure compared to the pseudo-continent and incontinent SB patients (resting pressure 56.5 vs. 32.5 mmHg). An abnormal CTT was associated with a treatment necessity to achieve pseudo-continence (p = 0.006). CTT in SB patients was significantly prolonged, indicating a neurogenic involvement of the bowel and slow transit constipation. SB patients with a normal CTT and a normal ARM spontaneously achieved fecal continence. CTT can help tailor the continence therapy in SB patients.
Keywords
Colon transit time, Spina bifida, Anorectal manometry, Child and young adult, FECAL INCONTINENCE, MYELOMENINGOCELE

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Chicago
Vande Velde, Saskia, LAURENCE PRATTE, HELENE VERHELST, VALERIE MEERSSCHAUT, Nele Herregods, Myriam Van Winckel, and Stephanie Van Biervliet. 2013. “Colon Transit Time and Anorectal Manometry in Children and Young Adults with Spina Bifida.” International Journal of Colorectal Disease 28 (11): 1547–1553.
APA
Vande Velde, Saskia, PRATTE, L., VERHELST, H., MEERSSCHAUT, V., Herregods, N., Van Winckel, M., & Van Biervliet, S. (2013). Colon transit time and anorectal manometry in children and young adults with spina bifida. INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 28(11), 1547–1553.
Vancouver
1.
Vande Velde S, PRATTE L, VERHELST H, MEERSSCHAUT V, Herregods N, Van Winckel M, et al. Colon transit time and anorectal manometry in children and young adults with spina bifida. INTERNATIONAL JOURNAL OF COLORECTAL DISEASE. 2013;28(11):1547–53.
MLA
Vande Velde, Saskia, LAURENCE PRATTE, HELENE VERHELST, et al. “Colon Transit Time and Anorectal Manometry in Children and Young Adults with Spina Bifida.” INTERNATIONAL JOURNAL OF COLORECTAL DISEASE 28.11 (2013): 1547–1553. Print.
@article{4116025,
  abstract     = {This study evaluates colon transit time (CTT) and anorectal manometry (ARM) in spina bifida (SB) patients in relation to the level of lesion, mobility, constipation, and continence status. 
SB patients between 6 and 19 years, who are not using antegrade continence enemas and followed at the SB Reference Centre UZ Ghent, were asked to participate. Medical history was retrospectively retrieved from the medical file. Stool habits were prospectively collected using standardized questionnaires. CTT was measured using the 6-day pellet abdominal X-ray method. ARM was performed in non-sedated children with a water-perfused, latex-free catheter. 
Forty out of 52 eligible patients consented to perform CTT, of which 19 also performed the ARM. Fifteen (37 \%) SB patients were constipated despite treatment. Twenty-six (65 \%) were (pseudo) continent. The total CTT was significantly prolonged in SB patients (median CTT 86.4 vs. 36 h controls). The CTT was significantly prolonged in constipated SB patients compared to non-constipated SB patients (122.4 vs. 52.8 h). Spontaneously continent patients had a normal CTT (33.6 h) as well as a significantly higher resting pressure compared to the pseudo-continent and incontinent SB patients (resting pressure 56.5 vs. 32.5 mmHg). An abnormal CTT was associated with a treatment necessity to achieve pseudo-continence (p = 0.006). 
CTT in SB patients was significantly prolonged, indicating a neurogenic involvement of the bowel and slow transit constipation. SB patients with a normal CTT and a normal ARM spontaneously achieved fecal continence. CTT can help tailor the continence therapy in SB patients.},
  author       = {Vande Velde, Saskia and PRATTE, LAURENCE and VERHELST, HELENE and MEERSSCHAUT, VALERIE and Herregods, Nele and Van Winckel, Myriam and Van Biervliet, Stephanie},
  issn         = {0179-1958},
  journal      = {INTERNATIONAL JOURNAL OF COLORECTAL DISEASE},
  language     = {eng},
  number       = {11},
  pages        = {1547--1553},
  title        = {Colon transit time and anorectal manometry in children and young adults with spina bifida},
  url          = {http://dx.doi.org/10.1007/s00384-013-1733-6},
  volume       = {28},
  year         = {2013},
}

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