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The predictive value of colon transit time and anorectal manometry in the approach of faecal continence in children with spina bifida

Charlotte Daeze (UGent) , Stephanie Van Biervliet (UGent) , Erik Van Laecke (UGent) , Myriam Van Winckel (UGent) , Ruth De Bruyne (UGent) , Ann De Guchtenaere (UGent) , Piet Hoebeke (UGent) and Saskia Vande Velde (UGent)
Author
Organization
Abstract
Purpose : The aim of this study is to analyse colon transit time (CTT) and anorectal manometry (ARM) in children with spina bifida (SB) as a predictor for achieving spontaneous faecal continence. Methods : SB patients (2.5-7 years old) followed at the SB Reference Centre Ghent University hospital underwent CTT and/or ARM before starting bowel management. A standardized questionnaire about the presence of constipation and faecal incontinence was completed. CTT was measured using a 6-day pellet abdominal X-ray method. ARM was performed in non-sedated children using a latex-free catheter. Results : Twenty-two patients were studied, with a median age of 4.57 years. They all underwent a CTT study, 17 (77%) also agreed to ARM 10/22 patients(45.5% )were constipated. 5/22 patients (22.7%) became spontaneously continent, 10/22 (45.5%) became pseudo-continent with bowel management, the others remained incontinent. SB patients had a significant prolonged CTT compared to healthy controls. In the group with an abnormal CTT study (12 patients), none of the patients developed faecal continence spontaneously, irrespective of the ARM result. In case of a normal CTT study (10 patients), 7 agreed to ARM. All children with normal resting pressure (4 patients) gained continence spontaneously. The 3 children with abnormal low resting pressure remained incontinent. Conclusions : This prospective study confirms the predictive value of normal CTT and normal resting pressure, in the evolution towards spontaneous faecal continence. If CTT is abnormal, irrespective of the ARM, bowel management will be necessary to obtain pseudo-continence. In these cases, ARM is not a designated examination.
Keywords
Spina bifida, Child, Faecal incontinence, Manometry, Transit Tune, HEALTHY-CHILDREN, INCONTINENCE, PATHOPHYSIOLOGY, MANAGEMENT

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MLA
Daeze, Charlotte et al. “The Predictive Value of Colon Transit Time and Anorectal Manometry in the Approach of Faecal Continence in Children with Spina Bifida.” ACTA GASTRO-ENTEROLOGICA BELGICA 81.2 (2018): 277–282. Print.
APA
Daeze, C., Van Biervliet, S., Van Laecke, E., Van Winckel, M., De Bruyne, R., De Guchtenaere, A., Hoebeke, P., et al. (2018). The predictive value of colon transit time and anorectal manometry in the approach of faecal continence in children with spina bifida. ACTA GASTRO-ENTEROLOGICA BELGICA, 81(2), 277–282.
Chicago author-date
Daeze, Charlotte, Stephanie Van Biervliet, Erik Van Laecke, Myriam Van Winckel, Ruth De Bruyne, Ann De Guchtenaere, Piet Hoebeke, and Saskia Vande Velde. 2018. “The Predictive Value of Colon Transit Time and Anorectal Manometry in the Approach of Faecal Continence in Children with Spina Bifida.” Acta Gastro-enterologica Belgica 81 (2): 277–282.
Chicago author-date (all authors)
Daeze, Charlotte, Stephanie Van Biervliet, Erik Van Laecke, Myriam Van Winckel, Ruth De Bruyne, Ann De Guchtenaere, Piet Hoebeke, and Saskia Vande Velde. 2018. “The Predictive Value of Colon Transit Time and Anorectal Manometry in the Approach of Faecal Continence in Children with Spina Bifida.” Acta Gastro-enterologica Belgica 81 (2): 277–282.
Vancouver
1.
Daeze C, Van Biervliet S, Van Laecke E, Van Winckel M, De Bruyne R, De Guchtenaere A, et al. The predictive value of colon transit time and anorectal manometry in the approach of faecal continence in children with spina bifida. ACTA GASTRO-ENTEROLOGICA BELGICA. 2018;81(2):277–82.
IEEE
[1]
C. Daeze et al., “The predictive value of colon transit time and anorectal manometry in the approach of faecal continence in children with spina bifida,” ACTA GASTRO-ENTEROLOGICA BELGICA, vol. 81, no. 2, pp. 277–282, 2018.
@article{8577085,
  abstract     = {Purpose : The aim of this study is to analyse colon transit time (CTT) and anorectal manometry (ARM) in children with spina bifida (SB) as a predictor for achieving spontaneous faecal continence. 
Methods : SB patients (2.5-7 years old) followed at the SB Reference Centre Ghent University hospital underwent CTT and/or ARM before starting bowel management. A standardized questionnaire about the presence of constipation and faecal incontinence was completed. CTT was measured using a 6-day pellet abdominal X-ray method. ARM was performed in non-sedated children using a latex-free catheter. 
Results : Twenty-two patients were studied, with a median age of 4.57 years. They all underwent a CTT study, 17 (77%) also agreed to ARM 10/22 patients(45.5% )were constipated. 5/22 patients (22.7%) became spontaneously continent, 10/22 (45.5%) became pseudo-continent with bowel management, the others remained incontinent. SB patients had a significant prolonged CTT compared to healthy controls. In the group with an abnormal CTT study (12 patients), none of the patients developed faecal continence spontaneously, irrespective of the ARM result. In case of a normal CTT study (10 patients), 7 agreed to ARM. All children with normal resting pressure (4 patients) gained continence spontaneously. The 3 children with abnormal low resting pressure remained incontinent. 
Conclusions : This prospective study confirms the predictive value of normal CTT and normal resting pressure, in the evolution towards spontaneous faecal continence. If CTT is abnormal, irrespective of the ARM, bowel management will be necessary to obtain pseudo-continence. In these cases, ARM is not a designated examination.},
  author       = {Daeze, Charlotte and Van Biervliet, Stephanie and Van Laecke, Erik and Van Winckel, Myriam and De Bruyne, Ruth and De Guchtenaere, Ann and Hoebeke, Piet and Vande Velde, Saskia},
  issn         = {1784-3227},
  journal      = {ACTA GASTRO-ENTEROLOGICA BELGICA},
  keywords     = {Spina bifida,Child,Faecal incontinence,Manometry,Transit Tune,HEALTHY-CHILDREN,INCONTINENCE,PATHOPHYSIOLOGY,MANAGEMENT},
  language     = {eng},
  number       = {2},
  pages        = {277--282},
  title        = {The predictive value of colon transit time and anorectal manometry in the approach of faecal continence in children with spina bifida},
  volume       = {81},
  year         = {2018},
}

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