Paediatric and adult colonic manometry: A tool to help unravel the pathophysiology of constipation

作     者：Philip G Dinning Marc A Benninga Bridget R Southwell S Mark Scott 

作者机构：Department of Gastroenterology St George Hospital University of New South Wales Kogarah Sydney 2217 Australia Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital/AMC Amsterdam 1105 AZ The Netherlands Murdoch Childrens Research Institute Royal Children's Hospital Parkville Melbourne 3052 Australia Department of Paediatrics University of Melbourne Melbourne 3052 Australia Queen Mary University London Barts and the London School of Medicine and Dentistry London E11BB United Kingdom 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2010年第16卷第41期

页      面：5162-5172页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by NH&MRC Australia (ID 630502) (to Dinning PG) 

主　　题：Colon Constipation Manometry Paediatric Adult 

摘      要：Colonic motility subserves large bowel functions, including absorption, storage, propulsion and defaecation. Co-lonic motor dysfunction remains the leading hypothesis to explain symptom generation in chronic constipation, a heterogeneous condition which is extremely prevalent in the general population, and has huge socioeconomic impact and individual suffering. Physiological testing plays a crucial role in patient management, as it is now accepted that symptom-based assessment, although im-portant, is unsatisfactory as the sole means of directing therapy. Colonic manometry provides a direct method for studying motor activities of the large bowel, and this review provides a contemporary understanding of how this technique has enhanced our knowledge of normalcolonic motor physiology, as well as helping to elucidate pathophysiological mechanisms underlying constipation. Methodological approaches, including available catheter types, placement technique and recording protocols, are covered, along with a detailed description of re-corded colonic motor activities. This review also criti-cally examines the role of colonic manometry in current clinical practice, and how manometric assessment may aid diagnosis, classification and guide therapeutic inter-vention in the constipated individual. Most importantly, this review considers both adult and paediatric patients. Limitations of the procedure and a look to the future are also addressed.