Colonic Manometry

What is Colonic Manometry?

Colonic manometry is a specialized test offered at Nationwide Children’s Hospital to measure how a child’s colon (large intestine) is working. It is usually used for children with constipation that is refractory to standard treatments. The test gives detailed information about how the muscles and nerves in the colon move stool forward.

The colon stores and removes waste from the body (stool) by squeezing in a coordinated way. Colonic manometry uses a thin, flexible tube called a catheter that has small pressure sensors along its length. The catheter is placed into the colon, and the sensors record pressure waves as the colon muscles contract. This shows how strong and how well organized the contractions are in different parts of the colon.

What Does This Test Help Diagnose?

Colonic manometry is most often used for children with:

• Long-lasting, severe constipation
• Stool accidents (fecal incontinence)
• Difficulty emptying the rectum or needing repeated cleanouts
• Problems that continue even after use of laxatives, enemas, and behavior plans

The patterns seen on the test help doctors tell the difference between normal colon function, slow transit constipation, and other neuromuscular problems of the colon. These results can guide decisions about medicines, bowel management programs, and whether procedures like an antegrade continence enema (ACE/cecostomy) or surgery may help.

How Should we Prepare?

Before the test, your child’s care team will review their medical history, current medicines, and any problems with anesthesia or breathing. Some medicines that affect gut movement may need to be stopped for a short time. Your child’s colon must be empty so the catheter can be placed (typically via colonoscopy) and the test can be read clearly. This usually means a bowel “cleanout” using a special solution, laxatives, or enemas, often with a clear liquid diet for a period of time. Your child may be admitted to the hospital before the test so the cleanout and preparation can be supervised and kept as comfortable as possible.

What Happens During the Test?

The catheter is usually placed during a colonoscopy while your child is asleep under anesthesia, or in interventional radiology with sedation. Once the catheter is in place, it is gently secured so it stays in position, and your child wakes up in a hospital room. The catheter is connected to a computer that records pressures over several hours.

During the study, your child may be asked to rest, change positions, eat a meal, or receive certain medicines, such as a medicine that stimulates the colon, to see how the colon responds. The care team will work to keep your child comfortable and explain each step as it happens.

What Happens After the Test?

When the recording is complete, the catheter is removed. Most children are able to go back to regular eating and gentle activity soon afterward, unless the care team advises otherwise. A pediatric motility specialist reviews the tracings from the test in detail and shares the results with you, usually at a follow-up visit. These results are used to fine-tune your child’s treatment plan so that bowel care is as effective and targeted as possible.

Why Choose Nationwide Children’s?

Colonic manometry at Nationwide Children’s is performed in the Neurogastroenterology and Motility Disorders Center, one of the few high-volume pediatric motility programs in the country. Our team includes pediatric motility specialists, gastroenterologists, surgeons, anesthesiologists, nurses, dietitians and psychologists who focus on children with complex constipation and defecation disorders. We use child-sized equipment, pediatric anesthesia and continuous monitoring to support safety and comfort throughout the test. Families travel from across the region and around the world for our expertise in advanced motility testing and our experience using colonic manometry results to guide medical therapy, bowel management programs and surgical decisions, with the goal of improving daily comfort, independence and quality of life.