The presence of breath methane in children with chronic constipation may suggest the possibility of prolonged colonic transit time.

Hydrogen excretion in breath after a bean test meal showed delayed oro-cecal transit time in children with chronic constipation with abnormal total colonic transit time.

Objective: To evaluate the effects of conventional treatment of chronic functional constipation on total and segmental colonic transit times and on orocecal transit time.Methods: A total of 34 consecutive patients with functional constipation attending a specialized outpatient clinic were included in the study. Total and segmental colonic transit times were assessed using radiopaque markers. Hydrogen breath test was used to evaluate lactulose and bean orocecal transit times. Treatment consisted of disimpaction, general and dietary fiber intake instruction, and mineral oil administration.Results: At admission, colonic dysmotility was found in 71.9% (23/32) of patients. All patients who complied with the treatment showed improvement of clinical symptoms after 6 weeks of treatment, when 82.6% (19/23) of those with dysmotility at admission returned to normal or reduced the severity of colonic transit patterns. Transit time decreased (medians) between admission and eighth week of treatment: lactulose orocecal transit (from 70 to 50 minutes, p = 0.002), bean orocecal transit (from 240 to 220 minutes, p = 0.002), and total colonic transit (from 69.5 to 37.0 hours, p = 0.001). The need for mineral oil therapy for constipation after a 12-month treatment was associated with persistence of total colonic transit higher than 62 hours at the eighth week of treatment (p = 0.014). Conclusion:The conventional therapeutic approach yielded good results regardless of the presence or not of colonic dysmotility at inclusion in the study. Digestive tract motility abnormalities in functionally constipated children may be reversed, and may be secondary to constipation. J Pediatr (Rio J). 2009;85(4):322-328:Gastrointestinal transit, constipation, therapy, pediatrics. ResumoObjetivo: Avaliar o efeito do tratamento convencional da constipação crônica funcional no tempo de trânsito colônico total e segmentar e no tempo de trânsito orocecal. Métodos:Foram incluídos 34 pacientes com constipação funcional atendidos consecutivamente em ambulatório especializado. O tempo de trânsito colônico total e segmentar foi avaliado com marcadores radiopacos. O tempo de trânsito orocecal da lactulose e do feijão foi avaliado com teste do hidrogênio no ar expirado. O tratamento constou de desimpactação, orientações gerais e de consumo de dieta rica em fibra alimentar e administração de óleo mineral.Resultados: Na admissão, dismotilidade colônica foi encontrada em 71,9% (23/32) dos pacientes. Todos os pacientes que realizaram corretamente o tratamento apresentaram melhora clínica na sexta semana do tratamento quando 82,6% (19/23) daqueles com dismotilidade na admissão apresentaram normalização ou diminuição da gravidade no padrão de trânsito colônico. Observou-se redução do tempo de trânsito (medianas) entre a admissão e a oitava semana de tratamento: trânsito orocecal da lactulose (de 70 para 50 minutos, p = 0,002), orocecal do feijão (de 240 para 220 minutos, p = 0,002) e colônico total (de 69,5 para 37,0 horas, p = 0,001). A necessidade de uso de ...

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Background: Constipation is prevalent in pediatric cystic fibrosis (CF) patients and colonic motility has not been studied in this population. In this study, we aimed to evaluate the total and segmental colonic transit time in children and adolescents with CF based on the presence of constipation and radiological fecal impaction. Methods: In this case series, all patients aged 3 to 20 years of a CF reference center were invited to participate. CF-associated constipation was diagnosed based on the European Society for Paediatric Gastroenterology Hepatology and Nutrition criteria. Total and segmental colonic transit time was determined using radiopaque markers. Fecal impaction on plain abdominal radiography was assessed based on the Barr score. Results: Of the 43 eligible patients, 34 (79%) agreed to participate. Constipation was found in 44.1% of children and adolescents, predominantly in girls. The total colonic transit time (medians of 42 and 24 hours, respectively, P ¼ 0.028) and the segmental right colon transit time (medians of 8 and 2 hours, respectively, P ¼ 0.012) were significantly longer in CF-associated constipation group than in the group of patients without constipation. The frequency of radiological fecal impaction was similar in patients with (50.0%) and without (64.2%) CF-associated constipation (P ¼ 0.70). There was no relationship between radiological fecal impaction and the total and segmental colonic transit time. Conclusions: Children and adolescents with CF-associated constipation had a longer total and segmental right colon transit time. Colonic transit time was similar in patients with and without radiological fecal impaction.