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165 Water-perfused colonic manometry 7 In the child with the repetitive long-single motor patterns (no. 16; Table 1), a strong colonic response was recorded in response to bisacodyl, with 15 HAPS recorded in a 22-min period. In child no. 12 (Table 1), bisacodyl infusion induced a series of HAPS which all terminated at the same location as the spontaneous HAPS (Figs 5 and 6). 60 sec Bisacodyl (5mg) 100 mmHg FIGURE 6: Bisacodyl induced high-amplitude propagating sequences (HAPS) induced in child no. 12. These chemically induced HAPS all terminated at the same location (solid black circle) as the spontaneous one shown in Fig. 5. Despite the initiation of these motor patterns, the child did not defecate. DISCUSSION In this study, utilizing high-resolution water-perfused manometry, we have quantified the motor patterns of the descending and sigmoid colon in children with chronic intractable constipation. Our data confirm the finding of previous adult studies that these children lack a normal meal response. 15,21 In addition, we demonstrate that in most subjects (16/18), HAPS were initiatedby colonic infusion of bisacodyl. Spontaneous HAPSwere only observed in two of 18 children. When these data are compared with fiber-optic high-resolution manometry recorded in healthy adults 17 and adults with slow-transit constipation 13 , several keys point emerge; (i) All four major colonic motor patterns described in healthy adults were present in the constipated children; (ii) the constipated children have a smaller number of motor patterns with 2–4 cpm (propagating or non-propagating) than either of the adult groups (Figure 2); (iii) the number of long-single propagating motor patterns recorded in children during the fasted period is significantly greater than in either adult group; (iv) the number of