Oftentimes we see a megacolon, we assume or we presume that the tone and compliance is going to be abnormal, that the It's going to be abnormal and the surgeons, uh, right, correctly or wrongly, will say, oh well, this is a non-functional colon, let's remove it.
Oftentimes we see a megacolon, we assume or we presume that the tone and compliance is going to be abnormal, that the It's going to be abnormal and the surgeons, uh, right, correctly or wrongly, will say, oh well, this is a non-functional colon, let's remove it.
Oftentimes we see a megacolon, we assume or we presume that the tone and compliance is going to be abnormal, that the It's going to be abnormal and the surgeons, uh, right, correctly or wrongly, will say, oh well, this is a non-functional colon, let's remove it.
Usually, a patient should be able to poop out all of those markers in 5 days, but Some remaining at the end of 5 days like shown in the left picture here and the right, it kind of indicates that the transit may be abnormal.
Usually, a patient should be able to poop out all of those markers in 5 days, but Some remaining at the end of 5 days like shown in the left picture here and the right, it kind of indicates that the transit may be abnormal.
Usually, a patient should be able to poop out all of those markers in 5 days, but Some remaining at the end of 5 days like shown in the left picture here and the right, it kind of indicates that the transit may be abnormal.
clinicalManometry is a catheter-based study of pressure changes within the lumen of the gut, involving visual pattern recognition of tracings to identify deviations from normal.↗
▶Ep 104 · 1:24
quoteManometry is really a catheter-based study of pressure changes within the lumen of the gut.↗
▶Ep 104 · 1:34
clinicalColonic motility has four key components: diameter of the colon, tone, compliance of the colonic wall, and contraction pressures (how strong the contractions are).↗
▶Ep 104 · 1:58
clinicalIn megacolon, tone and compliance are usually abnormal, but colonic manometry may still show normal high-amplitude propagated contractions and transit may be normal.↗
▶Ep 104 · 2:09
quoteOftentimes we see a megacolon, we assume or we presume that the tone and compliance is going to be abnormal, that the It's going to be abnormal and the surgeons, uh, right, correctly or wrongly, will say, oh well, this is a non-functional colon, let's remove it.↗
▶Ep 104 · 2:35
clinicalThere are three types of constipation: normal transit constipation, slow transit constipation (problem with neuromuscular integrity of colonic wall), and outlet obstruction or withholding (most common in anorectal malformation children).↗
▶Ep 104 · 3:19
clinicalIn a Sitz marker study, a patient should be able to pass all ingested radio-opaque markers in 5 days; markers remaining at 5 days indicate abnormal transit.↗
▶Ep 104 · 3:29
quoteUsually, a patient should be able to poop out all of those markers in 5 days, but Some remaining at the end of 5 days like shown in the left picture here and the right, it kind of indicates that the transit may be abnormal.↗
▶Ep 104 · 3:48
clinicalWhen Sitz markers are collected in the dilated rectum at 5 days, this is indicative of outlet obstruction or withholding.↗
▶Ep 104 · 4:06
clinicalWhen Sitz markers are scattered all over the colon at 5 days, this is indicative of slow transit constipation.↗
▶Ep 104 · 4:15
clinicalScintigraphy studies colonic transit by tracking the geometric center of an ingested isotope and can identify specific colonic locations with transit issues.↗
▶Ep 104 · 4:51
clinicalThe smart pill is a large capsule that measures pH, temperature, and pressure to assess transit from mouth to anus, but its size limits use to children approximately 10-12 years old or older.↗
▶Ep 104 · 6:05
clinicalThere are two main types of colonic contractions: phasic (brief) or tonic (sustained), with segmental non-propagated contractions being the most common.↗
▶Ep 104 · 6:19
clinicalHigh-amplitude propagated contractions (HAPCs) move stool along the length of the colon and correspond to what radiologists see on contrast enema as mass movement.↗
▶Ep 104 · 6:45
clinicalThe orthocolonic reflex (stimulus to colonic motility upon waking) and gastrocolonic reflex (stimulus upon eating) affect the timing of colonic contractions.↗
▶Ep 104 · 7:05
clinicalThe majority of HAPCs originate in the proximal colon, and most do not propagate beyond the midcolon; fewer than 5% reach the rectum.↗
▶Ep 104 · 7:05
quoteThe majority of these originate in the proximal colon, and most do not really propagate beyond the midcolon.↗
▶Ep 104 · 7:48
clinicalManometry catheters are typically placed during endoscopy, which allows evaluation of colonic mucosa, though interventional radiologists can also place them.↗
▶Ep 104 · 8:33
clinicalThe rectal motor complex appears as multiple small spikes on manometry tracings at the rectum.↗
▶Ep 104 · 9:07
clinicalSegmental dysmotility on manometry can show HAPCs present in the right colon but absent in the left colon.↗
▶Ep 104 · 10:07
clinicalIf more than 40 to 50 centimeters of colon does not have HAPCs, that segment is considered dysfunctional colon.↗
▶Ep 104 · 10:16
quoteTypically, we, our recommendations are if there's more than 40 to 50 centimeters of colon that's not working, does not have HAPCs, that's a dysfunctional colon.↗
▶Ep 104 · 10:48
clinicalThe first step in management is to maximize stimulant laxatives to ensure evacuation; if that fails, irrigation or enemas are tried before considering surgical interventions.↗
▶Ep 104 · 13:41
clinicalIn the presented case, duodenal and colonic manometry were normal, ruling out widespread dysmotility and confirming gastroparesis as the isolated abnormality.↗
▶Ep 104 · 14:03
quoteAnd I would say the answer is yes, because you, you've ruled out a more widespread dysmotility.↗
quoteManometry is really a catheter-based study of pressure changes within the lumen of the gut.↗
▶Ep 44 · 1:24
clinicalManometry is a catheter-based study of pressure changes within the lumen of the gut, involving visual pattern recognition of tracings to identify deviations from normal.↗
▶Ep 44 · 1:34
clinicalColonic motility has four key components: diameter of the colon, tone, compliance of the colonic wall, and contraction pressures (how strong the contractions are).↗
▶Ep 44 · 1:58
clinicalIn megacolon, tone and compliance are usually abnormal, but colonic manometry may still show normal high-amplitude propagated contractions and transit may be normal.↗
▶Ep 44 · 2:09
quoteOftentimes we see a megacolon, we assume or we presume that the tone and compliance is going to be abnormal, that the It's going to be abnormal and the surgeons, uh, right, correctly or wrongly, will say, oh well, this is a non-functional colon, let's remove it.↗
▶Ep 44 · 2:35
clinicalThere are three types of constipation: normal transit constipation, slow transit constipation (problem with neuromuscular integrity of colonic wall), and outlet obstruction or withholding (most common in anorectal malformation children).↗
▶Ep 44 · 3:19
clinicalIn a Sitz marker study, a patient should be able to pass all ingested radio-opaque markers in 5 days; markers remaining at 5 days indicate abnormal transit.↗
▶Ep 44 · 3:29
quoteUsually, a patient should be able to poop out all of those markers in 5 days, but Some remaining at the end of 5 days like shown in the left picture here and the right, it kind of indicates that the transit may be abnormal.↗
▶Ep 44 · 3:48
clinicalWhen Sitz markers are collected in the dilated rectum at 5 days, this is indicative of outlet obstruction or withholding.↗
▶Ep 44 · 4:06
clinicalWhen Sitz markers are scattered all over the colon at 5 days, this is indicative of slow transit constipation.↗
▶Ep 44 · 4:15
clinicalScintigraphy studies colonic transit by tracking the geometric center of an ingested isotope and can identify specific colonic locations with transit issues.↗
▶Ep 44 · 4:51
clinicalThe smart pill is a large capsule that measures pH, temperature, and pressure to assess transit from mouth to anus, but its size limits use to children approximately 10-12 years old or older.↗
▶Ep 44 · 6:05
clinicalThere are two main types of colonic contractions: phasic (brief) or tonic (sustained), with segmental non-propagated contractions being the most common.↗
▶Ep 44 · 6:19
clinicalHigh-amplitude propagated contractions (HAPCs) move stool along the length of the colon and correspond to what radiologists see on contrast enema as mass movement.↗
▶Ep 44 · 6:45
clinicalThe orthocolonic reflex (stimulus to colonic motility upon waking) and gastrocolonic reflex (stimulus upon eating) affect the timing of colonic contractions.↗
▶Ep 44 · 7:05
clinicalThe majority of HAPCs originate in the proximal colon, and most do not propagate beyond the midcolon; fewer than 5% reach the rectum.↗
▶Ep 44 · 7:05
quoteThe majority of these originate in the proximal colon, and most do not really propagate beyond the midcolon.↗
▶Ep 44 · 7:48
clinicalManometry catheters are typically placed during endoscopy, which allows evaluation of colonic mucosa, though interventional radiologists can also place them.↗
▶Ep 44 · 8:33
clinicalThe rectal motor complex appears as multiple small spikes on manometry tracings at the rectum.↗
▶Ep 44 · 9:07
clinicalSegmental dysmotility on manometry can show HAPCs present in the right colon but absent in the left colon.↗
▶Ep 44 · 10:07
clinicalIf more than 40 to 50 centimeters of colon does not have HAPCs, that segment is considered dysfunctional colon.↗
▶Ep 44 · 10:16
quoteTypically, we, our recommendations are if there's more than 40 to 50 centimeters of colon that's not working, does not have HAPCs, that's a dysfunctional colon.↗
▶Ep 44 · 10:48
clinicalThe first step in management is to maximize stimulant laxatives to ensure evacuation; if that fails, irrigation or enemas are tried before considering surgical interventions.↗
▶Ep 44 · 13:41
clinicalIn the presented case, duodenal and colonic manometry were normal, ruling out widespread dysmotility and confirming gastroparesis as the isolated abnormality.↗
▶Ep 44 · 14:03
quoteAnd I would say the answer is yes, because you, you've ruled out a more widespread dysmotility.↗
clinicalManometry is a catheter-based study of pressure changes within the lumen of the gut, involving visual pattern recognition of tracings to identify deviations from normal.↗
▶Ep 4 · 1:24
quoteManometry is really a catheter-based study of pressure changes within the lumen of the gut.↗
▶Ep 4 · 1:34
clinicalColonic motility has four key components: diameter of the colon, tone, compliance of the colonic wall, and contraction pressures (how strong the contractions are).↗
▶Ep 4 · 1:58
clinicalIn megacolon, tone and compliance are usually abnormal, but colonic manometry may still show normal high-amplitude propagated contractions and transit may be normal.↗
▶Ep 4 · 2:09
quoteOftentimes we see a megacolon, we assume or we presume that the tone and compliance is going to be abnormal, that the It's going to be abnormal and the surgeons, uh, right, correctly or wrongly, will say, oh well, this is a non-functional colon, let's remove it.↗
▶Ep 4 · 2:35
clinicalThere are three types of constipation: normal transit constipation, slow transit constipation (problem with neuromuscular integrity of colonic wall), and outlet obstruction or withholding (most common in anorectal malformation children).↗
▶Ep 4 · 3:19
clinicalIn a Sitz marker study, a patient should be able to pass all ingested radio-opaque markers in 5 days; markers remaining at 5 days indicate abnormal transit.↗
▶Ep 4 · 3:29
quoteUsually, a patient should be able to poop out all of those markers in 5 days, but Some remaining at the end of 5 days like shown in the left picture here and the right, it kind of indicates that the transit may be abnormal.↗
▶Ep 4 · 3:48
clinicalWhen Sitz markers are collected in the dilated rectum at 5 days, this is indicative of outlet obstruction or withholding.↗
▶Ep 4 · 4:06
clinicalWhen Sitz markers are scattered all over the colon at 5 days, this is indicative of slow transit constipation.↗
▶Ep 4 · 4:15
clinicalScintigraphy studies colonic transit by tracking the geometric center of an ingested isotope and can identify specific colonic locations with transit issues.↗
▶Ep 4 · 4:51
clinicalThe smart pill is a large capsule that measures pH, temperature, and pressure to assess transit from mouth to anus, but its size limits use to children approximately 10-12 years old or older.↗
▶Ep 4 · 6:05
clinicalThere are two main types of colonic contractions: phasic (brief) or tonic (sustained), with segmental non-propagated contractions being the most common.↗
▶Ep 4 · 6:19
clinicalHigh-amplitude propagated contractions (HAPCs) move stool along the length of the colon and correspond to what radiologists see on contrast enema as mass movement.↗
▶Ep 4 · 6:45
clinicalThe orthocolonic reflex (stimulus to colonic motility upon waking) and gastrocolonic reflex (stimulus upon eating) affect the timing of colonic contractions.↗
▶Ep 4 · 7:05
clinicalThe majority of HAPCs originate in the proximal colon, and most do not propagate beyond the midcolon; fewer than 5% reach the rectum.↗
▶Ep 4 · 7:05
quoteThe majority of these originate in the proximal colon, and most do not really propagate beyond the midcolon.↗
▶Ep 4 · 7:48
clinicalManometry catheters are typically placed during endoscopy, which allows evaluation of colonic mucosa, though interventional radiologists can also place them.↗
▶Ep 4 · 8:33
clinicalThe rectal motor complex appears as multiple small spikes on manometry tracings at the rectum.↗
▶Ep 4 · 9:07
clinicalSegmental dysmotility on manometry can show HAPCs present in the right colon but absent in the left colon.↗
▶Ep 4 · 10:07
clinicalIf more than 40 to 50 centimeters of colon does not have HAPCs, that segment is considered dysfunctional colon.↗
▶Ep 4 · 10:16
quoteTypically, we, our recommendations are if there's more than 40 to 50 centimeters of colon that's not working, does not have HAPCs, that's a dysfunctional colon.↗
▶Ep 4 · 10:48
clinicalThe first step in management is to maximize stimulant laxatives to ensure evacuation; if that fails, irrigation or enemas are tried before considering surgical interventions.↗
▶Ep 4 · 13:41
clinicalIn the presented case, duodenal and colonic manometry were normal, ruling out widespread dysmotility and confirming gastroparesis as the isolated abnormality.↗
▶Ep 4 · 14:03
quoteAnd I would say the answer is yes, because you, you've ruled out a more widespread dysmotility.↗
