Functional constipation or redundancy of the colon?

Noviello, C.; Nobile, Stefano; Romano, Mercedes; Mazzarini, Alessandra; Papparella, Alfonso; Cobellis, Giovanni

doi:10.1007/s12664-020-01034-x

Cited by 8 publications

(9 citation statements)

References 11 publications

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“…To standardize the results as much as possible and avoid weight and age-related variations, the ratios between the measured diameters of the various intestinal segments and the length of the sigmoid colon with the width of the body of the second lumbar vertebra (L2) were calculated. This same procedure has already been performed and reported by other authors as well as in our previous study of children with severe constipation older than 1 year [ 6 ]. The calculated ratios were compared with those reported as normal in one-year-old children in the literature [ 7 ].…”

Section: Methodsmentioning

confidence: 82%

“…The measurements were performed by three blind operators, but on the same image of the contrast enema, then an average was obtained between the three measurements. This method was also used in the control study [ 7 ] and in our previous article on redundancy in patients with constipation [ 6 ]. The aim is to obtain better results and to be able to compare them without fear of operator errors.…”

Section: Discussionmentioning

confidence: 99%

“…The aim of this study is to verify whether an intestinal anatomical problem (redundancy of the sigmoid colon), already found in pediatric patients as a cause of severe constipation refractory to medical treatment and sometimes the cause of sigmoid colon volvulus, occurs in infants with dyschezia. An early and accurate diagnosis of the anatomical abnormality is important to suspect acute problems and to adequately treat constipation in order to prevent severe forms [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Can Infant Dyschezia Be a Suspect of Rectosigmoid Redundancy?

et al. 2022

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Infant dyschezia is a functional gastrointestinal disorder that occurs in children less than nine months of age. This disorder causes much anxiety among parents who consult different physicians when suspecting major intestinal problems. The aim of this study is to verify whether infant dyschezia involves an anatomic abnormality (redundancy) of the colon. In this retrospective study (48 months) we analyzed all the children younger than 9 months who came to our attention through the suspicion of gastrointestinal abnormality (Hirschsprung’s disease, anorectal malformations, colonic disorders or constipation). They all had a complete medical history, clinical examination and diagnostic tests, such as blood samples, suction rectal biopsy, a study of stool characteristics and, finally, a contrast enema. In cases with infant dyschezia, different colonic sizes and rectosigmoid length were measured, which created a ratio with the diameter of the second lumbar vertebra. These values were compared with those reported in the literature as normal for the age of one year. Of the 24 patients evaluated (mean age 4 months), 9 were excluded for different diagnoses (aganglionic megacolon, hypothyroidism, constipation). The comparison of the ratios obtained in the remaining 15 cases showed a significantly higher rectosigmoid length (redundancy) in children with dyschezia, 18.47 vs. 9.75 (p < 0.001). The rectosigmoid redundancy, a congenital anomaly already reported as a cause of refractory constipation, may be present in children with infant dyschezia.

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Section: Methodsmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Can Infant Dyschezia Be a Suspect of Rectosigmoid Redundancy?

et al. 2022

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“…We thank Bolia and Kumar for their kind interest and comment on our article recently published in Indian J Gastroenterol. [1].…”

Section: To the Editorsmentioning

confidence: 99%

Author’s reply to comment on article: Redundant colon and refractory constipation in children

Noviello

Nobile

Romano

et al. 2020

Indian J Gastroenterol

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“…By calculating the various colonic diameters and lengths to the second lumbar vertebral body (L2), Koppen et al found that SCS ratios for the length of the rectosigmoid and the descending colon and the SCS ratio for sigmoid colon diameter were significantly larger in children with refractory constipation compared to a previously described normative population ( 19 ). Likewise, other attempts have been made to discover the relevance between the colonic diameters and length to the refractory constipation ( 12 , 20 ). It is believed that more attention and more intensive healthcare should be addressed for children with refractory constipation ( 1 ).…”

Section: Introductionmentioning

confidence: 99%

Artificial intelligence-powered early identification of refractory constipation in children

Huang,

Wan,

Yang

et al. 2024

Transl Pediatr

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Background Children experiencing refractory constipation, resistant to conventional pharmacological approaches, develop severe symptoms that persist into adulthood, leading to a substantial decline in their quality of life. Early identification of refractory constipation may improve their management. We aimed to describe the characteristics of colonic anatomy in children with different types of constipation and develop a supervised machine-learning model for early identification. Methods In this retrospective study, patient characteristics and standardized colon size (SCS) ratios by barium enema (BE) were studied in patients with functional constipation (n=77), refractory constipation (n=63), and non-constipation (n=65). Statistical analyses were performed and a supervised machine learning (ML) model was developed based on these data for the classification of the three groups. Results Significant differences in rectum diameter, sigmoid diameter, descending diameter, transverse diameter, and rectosigmoid length were found in the three groups. A linear support vector machine was utilized to build the early detection model. Using five features (SCS ratios of sigmoid colon, descending colon, transverse colon, rectum, and rectosigmoid), the model demonstrated an accuracy of 81% [95% confidence interval (CI): 79.17% to 83.19%]. Conclusions The application of using a supervised ML strategy obtained an accuracy of 81% in distinguishing children with refractory constipation. The combination of BE and ML model can be used for practical implications, which is important for guiding management in children with refractory constipation.

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Functional constipation or redundancy of the colon?

Cited by 8 publications

References 11 publications

Can Infant Dyschezia Be a Suspect of Rectosigmoid Redundancy?

Can Infant Dyschezia Be a Suspect of Rectosigmoid Redundancy?

Author’s reply to comment on article: Redundant colon and refractory constipation in children

Artificial intelligence-powered early identification of refractory constipation in children

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