Colonic Volume Changes in Paediatric Constipation Compared to Normal Values Measured Using MRI

Abstract

Background: Functional constipation in children is common. Management of this condition can be challenging and is often based on symptom reports. Increased, objective knowledge of colonic volume changes in constipation compared to health could provide additional information. However, very little data on paediatric colonic volume is available except from methods that are invasive or require unphysiological colonic preparations. Objectives: (1) To measure volumes of the undisturbed colon in children with functional constipation (FC) using magnetic resonance imaging (MRI) and provide initial normal range values for healthy controls, and (2) to investigate possible correlation of colonic volume with whole gut transit time (WGTT). Methods: Total and regional (ascending, transverse, descending, sigmoid, and rectum) colon volumes were measured from MRI images of 35 participants aged 7–18 years (16 with FC and 19 healthy controls), and corrected for body surface area. Linear regression was used to explore the relationship between total colon volume and WGTT. Results: Total colonic volume was significantly higher, with a median (interquartile range) of 309 mL (243–384 mL) for the FC group than for the healthy controls of 227 mL (180–263 mL). The largest increase between patients and controls was in the sigmoid colon–rectum region. In a linear regression model, there was a positive significant correlation between total colonic volume and WGTT (R = 0.56, p = 0.0005). Conclusions: This initial study shows increased volumes of the colon in children with FC, in a physiological state, without use of any bowel preparation. Increased knowledge of colonic morphology may improve understanding of FC in this age group and help to direct treatment.

Colonic volume in patients with functional constipation or irritable bowel syndrome determined by magnetic resonance imaging

“…In agreement with a previous studies, we found that patients with FC had significantly longer colonic transit times (median 4.9 days) than those with IBS‐C (median 1.8 days) 17,28 . A recent study in pediatric constipated patients found a positive correlation between whole gut transit times and colonic volume 15 . Colonic transit times have significant interindividual and day‐to‐day variation.…”

“…Moreover, semi‐automatic detection techniques reduce the time for otherwise comprehensive data analysis. Earlier studies have concluded that patients with constipation have larger colonic volumes than HC 14‐16 . Also, a previous study found that patients with FC had larger colonic volume than patients with IBS‐C, especially within the ascending colon 17 .…”

“…,28 A recent study in pediatric constipated patients found a positive correlation between whole gut transit times and colonic volume 15. Colonic transit times have signifi-cant interindividual and day-to-day variation.…”

Quantification of Fluid Volume and Distribution in the Paediatric Colon via Magnetic Resonance Imaging

“…The median total colonic volume (TCV) of healthy children aged 14–18 years is reported to be 227 mL (interquartile range 180 mL–263 mL) [ 53 ], whereas the mean healthy adult TCV is 760 mL (with a 95% confidence interval of 662 mL–858 mL) [ 27 , 54 ]. Similarly, the length of the colon increases with age, from 52 cm length in children younger than 2 years of age to 150 cm in adults [ 55 ].…”

Alterations in infant gut microbiome composition and metabolism after exposure to glyphosate and Roundup and/or a spore-based formulation using the SHIME technology

“…This would represent 525–600 mg (NOAEL) or 5.3–6 mg (ADI) of glyphosate in feces for an infant (15 kg). Considering colonic volume of healthy infants around 0.2 L (Sharif et al, 2021), NOAEL levels of glyphosate could represent 2,625–3,000 mg/L in feces, and ADI levels of glyphosate 100-time lower values. We used 100 mg/L, a dose in between these two reference values.…”