Bisacodyl and high-amplitude-propagating colonic contractions in children.

BACKGROUND The purpose of these studies was to determine the suitability of bisacodyl for stimulating high-amplitude-propagating contractions in pediatric studies of colonic manometry. METHODS Water-perfused manometry catheters were inserted into the right colon of children referred for evaluations related to defecation disorders. Colonic motility was measured in a 3-hour test session: an hour fasting, an hour after a meal, and 30 minutes after administration of a provocative agent. RESULTS Bisacodyl was superior to edrophonium as a stimulant for inducing high-amplitude-propagating contractions. Bisacodyl-induced high-amplitude-propagating contractions were similar in amplitude, duration, propagation velocity, and sites of origin and extinction to naturally occurring high-amplitude-propagating contractions. The effect of intrarectal bisacodyl was similar to that of intracecal bisacodyl, except for a delay of 10 minutes in onset. Bisacodyl induced high-amplitude-propagating contractions in all 28 children (22 with spontaneous high-amplitude-propagating contractions) without evidence of neuromuscular disease and in 2 of 9 children with a colonic neuromuscular disorder and no spontaneous high-amplitude-propagating contractions. CONCLUSIONS Bisacodyl-induced high-amplitude-propagating contractions were quantitatively and qualitatively similar to naturally occurring high-amplitude-propagating contractions. In selected cases, such as in children receiving total parenteral nutrition or restricted fluid intake, it may be possible to shorten diagnostic colonic manometry using bisacodyl rather than waiting for spontaneous high-amplitude-propagating contractions.

[1]  C. Di Lorenzo,et al.  Diagnosis and treatment of chronic intestinal pseudo-obstruction in children: report of consensus workshop. , 1997, Journal of pediatric gastroenterology and nutrition.

[2]  C. Di Lorenzo,et al.  Age-related changes in colon motility. , 1995, The Journal of pediatrics.

[3]  C. Di Lorenzo,et al.  Antroduodenal manometry in children and adults with severe non-ulcer dyspepsia. , 1994, Scandinavian journal of gastroenterology.

[4]  C. Di Lorenzo,et al.  Colonic manometry in children with chronic intestinal pseudo-obstruction. , 1993, Gut.

[5]  G. Riezzo,et al.  Electrogastrography in non-ulcer dyspepsia. , 1992, Archives of disease in childhood.

[6]  C. Di Lorenzo,et al.  Use of colonic manometry to differentiate causes of intractable constipation in children. , 1992, The Journal of pediatrics.

[7]  W. Roth,et al.  [Pharmacokinetics and laxative effect of bisacodyl following administration of various dosage forms]. , 1988, Arzneimittel-Forschung.

[8]  A. Morelli,et al.  Twenty four hour manometric recording of colonic motor activity in healthy man. , 1987, Gut.

[9]  D. Saunders,et al.  Effect of bisacodyl on the structure and function of rodent and human intestine. , 1977, Gastroenterology.

[10]  D. Sigman,et al.  Ligand binding properties of acetylcholinesterase determined with fluorescent probes. , 1974, Biochemistry.

[11]  G. Genkins,et al.  CRITICAL REAPPRAISAL OF THE USE OF EDROPHONIUM (TENSILON) CHLORIDE TESTS IN MYASTHENIA GRAVIS AND SIGNIFICANCE OF CLINICAL CLASSIFICATION * † , 1966, Annals of the New York Academy of Sciences.

[12]  Hawk Jc,et al.  USE OF A CONTACT LAXATIVE SOLUTION (DULCOLAX) AS AN ADJUNCT IN COLOSTOMY CONTROL. , 1964 .