Pediatr Gastroenterol Hepatol Nutr.  2020 Mar;23(2):137-145. 10.5223/pghn.2020.23.2.137.

Does the Oral-Anal Transit Test Correlate with Colonic Manometry Findings in Children with Refractory Constipation?

Affiliations
  • 1Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Atrium Health Levine Children's Hospital, Charlotte, NC, USA. Jason.dranove@yahoo.com
  • 2Department of Pediatric Gastroenterology, Children's Mercy Hospital, Kansas City, MO, USA.
  • 3Department of Public Health, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
  • 4Division of Pediatric Surgery, Atrium Health Levine Children's Hospital, Charlotte, NC, USA.

Abstract

PURPOSE
The Oral-anal Transit Test (OTT) is a simple method of obtaining information about colonic transit. We aim to assess the correlation of OTT with the neuromuscular integrity of the colon determined by colonic manometry (CM).
METHODS
All patients who had OTT followed by CM were evaluated. Less than 6 of 24 markers remaining on OTT was considered normal. CM was performed per previously published guidelines. A normal CM was defined as at least one High Amplitude Propagating Contraction progressing from the most proximal sensor through the sigmoid colon.
RESULTS
A total of 34 patients underwent both OTT and CM (44% male, age 4-18 years, mean 11.5 years, 97% functional constipation +/− soiling, Hirschsprung's Disease). Of normal and abnormal OTT patients, 85.7% (6/7) and 18.5% (5/27) respectively had normal CM. When all markers progressed to at least the sigmoid colon, this was 100% predictive against colonic inertia. Greater than 50% of patients with manometric isolated sigmoid dysfunction had markers proximal to the recto-sigmoid.
CONCLUSION
OTT and CM are both valuable studies that assess different aspects of colonic function. OTT can be used as a screening test to rule out colonic inertia. However, the most proximal extent of remaining markers does not predict the anatomical extent of the manometric abnormality, particularly in isolated sigmoid dysfunction.

Keyword

Gastrointestinal dysmotility; Fecal incontinence; Constipation; Colonic inertia; Colonic manometry

MeSH Terms

Child*
Colon*
Colon, Sigmoid
Constipation*
Fecal Incontinence
Humans
Male
Manometry*
Mass Screening
Methods
Soil
Soil
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