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World J Gastroenterol. Nov 7, 2010; 16(41): 5162-5172
Published online Nov 7, 2010. doi: 10.3748/wjg.v16.i41.5162
Paediatric and adult colonic manometry: A tool to help unravel the pathophysiology of constipation
Philip G Dinning, Marc A Benninga, Bridget R Southwell, S Mark Scott
Philip G Dinning, Department of Gastroenterology, St George Hospital, University of New South Wales, Kogarah, Sydney 2217, Australia
Marc A Benninga, Department of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital/AMC, Amsterdam, 1105 AZ, The Netherlands
Bridget R Southwell, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne 3052, Australia
Bridget R Southwell, Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
S Mark Scott, Queen Mary University London, Barts and the London School of Medicine and Dentistry, London, E11BB, United Kingdom
Author contributions: Dinning PG and Scott SM provided the adult colonic manometry material; Southwell BR and Benninga MA provided the paediatric information; all authors contributed to writing of the paper.
Supported by NH&MRC Australia (ID 630502) (to Dinning PG)
Correspondence to: Dr. Philip G Dinning, Department of Gastroenterology, St George Hospital, University of New South Wales, Kogarah, Sydney 2217, Australia. p.dinning@unsw.edu.au
Telephone: +61-2-93502817 Fax: +61-2-93503993
Received: May 27, 2010
Revised: June 26, 2010
Accepted: July 3, 2010
Published online: November 7, 2010

Colonic motility subserves large bowel functions, including absorption, storage, propulsion and defaecation. Colonic 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 important, 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 normal colonic 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 recorded colonic motor activities. This review also critically examines the role of colonic manometry in current clinical practice, and how manometric assessment may aid diagnosis, classification and guide therapeutic intervention 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.

Keywords: Colon, Constipation, Manometry, Paediatric, Adult