Letter to Editor Comments on: Antegrade continence enema treatment can lead to proximal colonic dilation while preserving motility in children with constipation

We read with interest the retrospective study by van der Zande and colleagues [1] evaluating colonic motility and anatomy in 70 children treated with antegrade continence enema (ACE). The authors report proximal colonic dysmotility in 6% and proximal dilation in 20% of patients with paired contrast enema (CE) data, with longer ACE duration as a contributing factor. This work addresses an important clinical question. However, we wish to raise three methodological considerations.