Colonic transit studies and colonic manometry in pediatric constipation
Bibliographic record
Abstract
OBJECTIVES: In a subgroup of children with refractory constipation, colonic function investigations, such as colonic transit scintigraphy (CS) and colonic manometry (CM), are used to define the underlying pathophysiologic mechanisms. There are limited studies comparing colonic transit and contractile function. We aimed to correlate CS and CM and assess whether specific manometric patterns might predict the luminal transit findings. METHODS: Children with refractory constipation undergoing both CS and CM between 2012 and 2022 at two Tertiary Pediatric Gastroenterology Services were retrospectively reviewed. For CS, the geometric center (GC) was used to quantify the transit across the different colonic segments and studies were categorized into normal transit, recto-sigmoid hold-up, and slow transit. Contractile patterns from CM were classified into equivalent regional subtypes as normal, distal colonic dysmotility and pan-colonic dysmotility, respectively. RESULTS: Twenty-two patients (59% male, median age: 10.94 years) were included. No significant agreement in the subtype of constipation was found between CS and CM (K = 0.224, p = 0.070). However, a strong correlation was observed between the numeric score of the GC at 6 h and the amplitude of bisacodyl-induced high amplitude propagating contractions (HAPCs) in the rectosigmoid (r = 0.761, p = 0.007). Moreover, a higher percentage of radiotracers in the ascending colon at 24 h was related to a higher number of bisacodyl-induced HAPCs. CONCLUSIONS: Scintigraphic GC at 6 h showed a substantial correlation with parameters from CM in the rectosigmoid colon, implicating the potential role of this colonic region as a gatekeeper for colonic luminal transit.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".