Colonic Manometry in Pediatric Patients with Spina Bifida: Results from a Retrospective Cohort Study

TL;DR

This study found that colonic motility is normal in most children with spina bifida and bowel issues, suggesting that non-invasive treatments should be prioritized.

Contribution

The study provides new insights into the role of colonic motility in spina bifida-related bowel dysfunction.

Findings

Most patients had normal colonic motility despite bowel dysfunction.

Anorectal dysfunction or slow transit constipation may be more significant in these patients.

Conservative therapies should be maximized before invasive interventions.

Abstract

Background/Objectives: Patients with spina bifida (SB) commonly experience neurogenic bowel dysfunction, characterized by defecation-related symptoms. While anorectal dysfunction and slow transit constipation (STC) have been implicated, the role of colonic motility in SB remains unclear. This study aimed to evaluate colonic motility in SB patients with refractory bowel dysfunction. Methods: This retrospective cohort study included SB patients who failed the repeated optimization of a bowel regimen including stimulant laxatives and subsequently underwent anorectal manometry (ARM), colonic transit time (CTT) studies, or colonic manometry (CM). Diagnostic findings were analyzed alongside treatment outcomes. Results: A total of 13 patients with myelomeningocele were included; one declined further treatment, and 12 underwent treatment optimization, with four achieving bowel continence. Of the five patients who proceeded with advanced motility testing, two had abnormal ARM findings, one of three had abnormal CTT results, and all five had normal CM findings. Conclusions: These findings suggest that anorectal dysfunction or STC may play a larger role in refractory bowel symptoms, while colonic motility appears to be preserved, and this highlights the importance of maximizing conservative therapies, particularly with stimulant laxatives, before pursuing invasive tests or surgical interventions for bowel dysfunction in this population.

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