Colonic Manometry :: Nationwide Children's Hospital

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Colonic Manometry

Gastrointestinal motility (moe-TILL-it-ee) is the movement of the food we eat through the entire digestive tract (Picture 1). The length of the digestive tract is about 30 feet from the mouth to the rectum. Digestion occurs when the nerves and muscles in the digestive tract work together to move the food along.

Purpose of this Test

Picture 1 The colon is also called the large bowel or large intestine

The colon (also called the large intestine or bowel) stores and removes waste material by muscle contraction. The colonic manometry
(koe-LON-ik mah-NOM-eh-tree) test records the pressure waves that are produced when the large intestines contract.
Pressures in the large intestines and the strength and coordination of muscle contractions are measured before and after eating. These measurements provide detailed information on how well the large intestines are working.

Home Preparation

Your child’s intestines must be cleaned out completely before the test can be done.
On (day) ___________ (date) ___________, give your child clear liquids starting with breakfast.
Clear liquids are those you can see through that have no pulp or food bits in them. They include water, white grape juice, Pedialyte®, apple juice, Gatorade®, Kool-Aid®, flavored gelatin, popsicles and broth with no noodles.
1. Your child should not take aspirin, ibuprofen (Motrin® and Advil®) or naproxyn (Aleve®) one week before the procedure and for 3 days after the procedure. Your child may take acetaminophen (Tylenol®).
2. On (day)___________ (date)____________, give your child the following:
  •  Dulcolax® (bisacodyl) 5mg tablet(s), _______ tablets at____AM and ____PM.
  •  Dulcolax® (bisacodyl) suppository, ____ suppository at ____AM and ____PM.
  •  Miralax® (polyethylene glycol 3350). Mix ________ gm (which is______ capfuls filled to dosage line inside cap) in __________ ounces of Gatorade®, Kool-Aid® or any other clear liquid.
  •  Other: __________________________________________________________

Hospital Preparation

The First Day of the Test

On the day of admission (day) _____________ (date) ____________________ your child may NOT have anything to eat or drink after __________________________.
  •  A nasogastric tube (NG-tube) will be placed. This tube will be used to give a cleansing solution to finish cleaning out the bowels. It will be given until stools are clear and liquid.
  •  If your child has a G-tube or GJ-tube, it will be used to give the cleansing solution.
  •  Any female who is menstruating or is 12 years of age or older will get a urine pregnancy test at the hospital on the day of the test.
  •  Please tell your doctor if your child has had problems with sedation in the past. Also tell the doctor if your child has a heart condition, apnea or other breathing problems. This will help the doctor decide which type of sedation is best for your child.
  •  Other:__________________________________________________________________.
  •  An IV (intravenous catheter) will be started.
  •  Your child’s test is scheduled for_______________________ (date) at ___________ (time).

How the Test Is Done

The way that the test is done will be tailored to your child’s needs:
  •  Your child will be taken to the Operating Room for catheter placement, where he will fall asleep with general anesthesia.
  •  Your child will be taken to Interventional Radiology (IR) in his hospital bed. You may go with him or her. The radiologist will explain the test and get consent from the parent or legal guardian.
  • Your child will be taken to the G.I. procedure room for catheter placement, where he will fall asleep with general anesthesia
  • A PARENT OR LEGAL GUARDIAN MUST BE PRESENT to give consent for the test and for the sedation or anesthesia. If a parent or legal guardian is not available, please provide a phone number where a nurse and doctor can reach them at the time of the test.
  •  Your child’s doctor and the radiologist will decide the best way to sedate your child for this test. The sedation team will give your child either sedation medicine through the IV or general anesthesia in Radiology.
  •  A nurse will connect your child to monitors so that they can check your child’s heart rate, breathing, oxygen levels and blood pressure. The nurse and the anesthesia doctor will monitor your child throughout the test.
  •  You may stay with your child until the test begins. Then you may wait in the IR waiting room or the Surgery waiting room. If your child has had sedation, the nurse will come for you after the tube has been placed. The nurse will take you and your child to the GI motility room unless other directions are given. If your child has had general anesthesia, he will go to the PACU (Post Anesthesia Care Unit) until he is fully awake. Then your child will go to the GI motility room unless other directions have been given.
  •  Once your child is relaxed or asleep, a long, flexible tube (motility catheter) will be placed into the colon through the rectum. X-ray pictures will be taken to help the radiologist put the tube in the right place. This catheter has holes spaced evenly apart that measure the pressure in different areas of the colon.
  •  Medicines can affect the contractions of the colon, so the actual pressure measurements will not start until after your child is fully awake.
  •  The motility catheter is connected to a computer. Water is slowly pushed through each hole in the catheter. The computer records the pressures against the water as it tries to flow out of the catheter.
  •  During the testing, we will try to change the contraction of the intestines. Your child may be given medicines through the motility catheter or IV. We may also give food or medicine by mouth. After this, the recordings continue for another hour.
  •  From start to finish, the measurement of pressures usually takes 4 to 8 hours.

Risks and Possible Complications

  •  Perforation (hole in the colon) can occur. This is very rare unless the colon is extremely diseased and thin. Perforations usually require surgery to repair the hole.
  •  Infections can occur. This is rare unless your child has a heart problem or problems with the immune system. In these cases, antibiotics are usually given.
  •  This test requires a certain amount of cooperation from the child. If it is too hard for your child to cooperate, we may have to stop the test.
If you have any questions, be sure to ask your doctor or nurse.
 
 
HH-III-104 9/05, Revised 7/13 Copyright 2005, Nationwide Children’s Hospital
Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000