14781-koppen

171 Water-perfused colonic manometry 7 Finally, some of these children had a dilated colon (Figure 1 and 5), which may have been a consequence of the severe constipation symptoms, such as the long-lasting fecal stasis. This could indicate pathological differences in the colonic structure between some of the children and the adults, and this may account for some of the manometric differences seen. However, we were able to record motor patterns in all children, regardless of the colon diameter. In addition, the colonic meal response was absent in all children; therefore, colonic dilation cannot account for this manometric finding. In conclusion, as seen in adults with slow-transit constipation, high-resolution colonic manometry enables quantification of motor pattern abnormalities in children with chronic intractable constipation. Results show that these children lack a physiological increase of retrograde cyclic propagating motor patters after the meal and have significantly more long-single propagating motor patterns prior to a meal. Spontaneous postprandial HAPS were rarely seen in children; however, they could be induced by bisacodyl in the majority. Future research should focus on all identified colonic motor patterns rather than on HAPS alone. ACKNOWLEDGMENTS PD and LW receive funding from the National Health and Medical Research Council of Australia (ID: 1064835). The authors would like to thank J.M. Oors for his support and help with the pediatric colonic manometry studies.