Imaging in pediatric disorders of the gut-brain interactions: current best practice and future directions

References

• Hyams JS, Di Lorenzo C, Saps M, et al. Functional disorders: children and adolescents. Gastroenterology. 2016;150(6):1456–1468.e2. doi: 10.1053/j.gastro.2016.02.015
   Web of Science ®Google Scholar
• Korterink JJ, Diederen K, Benninga MA, et al. Epidemiology of pediatric functional abdominal pain disorders: a meta-analysis. PLoS One. 2015;10(5):e0126982. doi: 10.1371/journal.pone.0126982
   PubMed Web of Science ®Google Scholar
• Koppen IJN, Vriesman MH, Saps M, et al. Prevalence of functional defecation disorders in children: a systematic review and meta-analysis. J Pediatr. 2018;198:121–130 e126. doi: 10.1016/j.jpeds.2018.02.029
   PubMed Web of Science ®Google Scholar
• Rajindrajith S, Gunawardane D, Kuruppu C, et al. Epidemiology of aerophagia in children and adolescents: a systematic review and meta-analysis. PLoS One. 2022;17(7):e0271494. doi:10.1371/journal.pone.0271494
   PubMed Web of Science ®Google Scholar
• Rajindrajith S, Devanarayana NM, Weerasooriya L, et al. Quality of life and somatic symptoms in children with constipation: a school-based study. J Pediatr. 2013;163(4):1069–1072 e1061. doi:10.1016/j.jpeds.2013.05.012
   PubMed Web of Science ®Google Scholar
• Devanarayana NM, Rajindrajith S, Benninga MA. Quality of life and health care consultation in 13 to 18 year olds with abdominal pain predominant functional gastrointestinal diseases. BMC Gastroenterol. 2014;14(1):150. doi: 10.1186/1471-230X-14-150
   PubMedGoogle Scholar
• Ranasinghe N, Devanarayana NM, Rajindrajith S, et al. Functional gastrointestinal diseases and psychological maladjustment, personality traits and quality of life. BMC Gastroenterol. 2018;18(1):33. doi: 10.1186/s12876-018-0760-8
   PubMedGoogle Scholar
• Ranasinghe N, Devanarayana NM, Benninga MA, et al. Psychological maladjustment and quality of life in adolescents with constipation. Arch Dis Child. 2017;102(3):268–273. doi:10.1136/archdischild-2016-310694
   PubMed Web of Science ®Google Scholar
• Rajindrajith S, Ranathunga N, Jayawickrama N, et al. Behavioral and emotional problems in adolescents with constipation and their association with quality of life. PLoS One. 2020;15(10):e0239092. doi:10.1371/journal.pone.0239092
   PubMed Web of Science ®Google Scholar
• Park R, Mikami S, LeClair J, et al. Inpatient burden of childhood functional GI disorders in the USA: an analysis of national trends in the USA from 1997 to 2009. Neurogastroenterol Motil. 2015;27(5):684–692. doi: 10.1111/nmo.12542
   PubMed Web of Science ®Google Scholar
• Ansari H, Ansari Z, Lim T, et al. Factors relating to hospitalisation and economic burden of paediatric constipation in the state of Victoria, Australia, 2002-2009. J Paediatr Child Health. 2014;50(12):993–999. doi:10.1111/jpc.12675
   PubMed Web of Science ®Google Scholar
• Corban C, Sommers T, Sengupta N, et al. Fecal impaction in the emergency department: an analysis of frequency and associated charges in 2011. J Clin Gastroenterol. 2016;50(7):572–577. doi: 10.1097/MCG.0000000000000458
   PubMed Web of Science ®Google Scholar
• MacGeorge CA, Simpson KN, Basco WT Jr., et al. Constipation-related emergency department use, and associated Office Visits and payments among commercially insured children. Acad Pediatr. 2018;18(8):952–956. doi:10.1016/j.acap.2018.04.004
   PubMed Web of Science ®Google Scholar
• Chogle A, Saps M. Yield and cost of performing screening tests for constipation in children. Can J Gastroenterol. 2013;27(12):e35–38. doi:10.1155/2013/945165
   PubMedGoogle Scholar
• Gijsbers CF, Benninga M, Buller H. Clinical and laboratory findings in 220 children with recurrent abdominal pain. Acta Paediatr. 2011;100(7):1028–1032. doi:10.1111/j.1651-2227.2011.02179.x
   PubMed Web of Science ®Google Scholar
• Eidlitz-Markus T, Mimouni M, Zeharia A, et al. Occult constipation: a common cause of recurrent abdominal pain in childhood. Isr Med Assoc J. 2004;6(11):677–680.
   PubMed Web of Science ®Google Scholar
• Hoekman DR, Zeevenhooven J, van Etten-Jamaludin FS, et al. The placebo response in pediatric abdominal pain-related functional gastrointestinal disorders: a systematic review and meta-analysis. J Pediatr. 2017;182:155–163 e157. doi: 10.1016/j.jpeds.2016.12.022
   PubMed Web of Science ®Google Scholar
• Hwang JB, Choi WJ, Kim JS, et al. Clinical features of pathologic childhood aerophagia: early recognition and essential diagnostic criteria. J Pediatr Gastroenterol Nutr. 2005;41(5):612–616. doi: 10.1097/01.mpg.0000179856.68968.e0
   PubMed Web of Science ®Google Scholar
• Linet MS, Kim KP, Rajaraman P. Children’s exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations. Pediatr Radiol. 2009;39(Suppl 1):S4–26. doi:10.1007/s00247-008-1026-3
   PubMedGoogle Scholar
• Barr RG, Levine MD, Wilkinson RH, et al. Chronic and occult stool retention: a clinical tool for its evaluation in school-aged children. Clin Pediatr (Phila). 1979;18(11):677–679. doi:10.1177/000992287901801103
   Web of Science ®Google Scholar
• Blethyn AJ, Verrier Jones K, Newcombe R, et al. Radiological assessment of constipation. Arch Dis Child. 1995;73(6):532–533. doi:10.1136/adc.73.6.532
   PubMed Web of Science ®Google Scholar
• Leech SC, McHugh K, Sullivan PB. Evaluation of a method of assessing faecal loading on plain abdominal radiographs in children. Pediatr Radiol. 1999;29(4):255–258. doi:10.1007/s002470050583
   PubMed Web of Science ®Google Scholar
• Starreveld JS, Pols MA, Van Wijk HJ, et al. The plain abdominal radiograph in the assessment of constipation. Z Gastroenterol. 1990;28(7):335–338.
   PubMed Web of Science ®Google Scholar
• Pensabene L, Buonomo C, Fishman L, et al. Lack of utility of abdominal x-rays in the evaluation of children with constipation: comparison of different scoring methods. J Pediatr Gastroenterol Nutr. 2010;51(2):155–159. doi:10.1097/MPG.0b013e3181cb4309
   PubMed Web of Science ®Google Scholar
• Reuchlin-Vroklage LM, Bierma-Zeinstra S, Benninga MA, et al. Diagnostic value of abdominal radiography in constipated children: a systematic review. Archives Of Pediatrics & Adolescent Medicine. 2005;159(7):671–678. doi:10.1001/archpedi.159.7.671
   PubMedGoogle Scholar
• Berger MY, Tabbers MM, Kurver MJ, et al. Value of abdominal radiography, colonic transit time, and rectal ultrasound scanning in the diagnosis of idiopathic constipation in children: a systematic review. J Pediatr. 2012;161(1):44-50 e41–42. doi: 10.1016/j.jpeds.2011.12.045
   Web of Science ®Google Scholar
• Benninga MA, Buller HA, Staalman CR, et al. Defaecation disorders in children, colonic transit time versus the Barr-score. Eur J Pediatr. 1995;154(4):277–284. doi: 10.1007/BF01957362
   PubMed Web of Science ®Google Scholar
• Beckmann KR, Hennes H, Sty JR, et al. Accuracy of clinical variables in the identification of radiographically proven constipation in children. WMJ. 2001;100(1):33–36.
   PubMedGoogle Scholar
• de Lorijn F, van Rijn RR, Heijmans J, et al. The Leech method for diagnosing constipation: intra- and interobserver variability and accuracy. Pediatr Radiol. 2006;36(1):43–49. doi: 10.1007/s00247-005-0031-z
   PubMed Web of Science ®Google Scholar
• Tabbers MM, DiLorenzo C, Berger MY, et al. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014;58(2):258–274. doi: 10.1097/MPG.0000000000000266
   PubMed Web of Science ®Google Scholar
• Yachha SK, Srivastava A, Mohan N, et al. Management of childhood functional constipation: Consensus practice guidelines of Indian Society of pediatric Gastroenterology, Hepatology and Nutrition and pediatric Gastroenterology chapter of Indian Academy of Pediatrics. Indian Pediatr. 2018;55(10):885–892. doi: 10.1007/s13312-018-1402-5
   PubMed Web of Science ®Google Scholar
• Excellence NIfHa.Constipation in children and young people: diagnosis and management. London: Royal College of Obstetricians and Gynaecologists; 2010. p. 1–32. https://www.ncbi.nlm.nih.gov/books/NBK554924/pdf/Bookshelf_NBK554924.pdf
   Google Scholar
• Nutter A, Meckler G, Truong M, et al. Constipation and paediatric emergency department utilization. Paediatr Child Health. 2017;22(3):139–142. doi:10.1093/pch/pxx041
   PubMed Web of Science ®Google Scholar
• Chumpitazi CE, Rees CA, Camp EA, et al. Diagnostic approach to constipation impacts pediatric emergency department disposition. Am J Emerg Med. 2017;35(10):1490–1493. doi:10.1016/j.ajem.2017.04.060
   PubMed Web of Science ®Google Scholar
• Beinvogl B, Sabharwal S, McSweeney M, et al. Are we using abdominal radiographs appropriately in the management of pediatric constipation? J Pediatr. 2017;191:179–183. doi:10.1016/j.jpeds.2017.08.075
   PubMed Web of Science ®Google Scholar
• McSweeney ME, Chan Yuen J, Meleedy-Rey P, et al. A quality improvement initiative to reduce abdominal X-ray use in pediatric patients presenting with constipation. J Pediatr. 2022;251:127–133. doi:10.1016/j.jpeds.2022.07.016
   PubMed Web of Science ®Google Scholar
• Ferguson CC, Gray MP, Diaz M, et al. Reducing unnecessary imaging for patients with constipation in the pediatric emergency department. Pediatrics. 2017;140(1). doi: 10.1542/peds.2016-2290
   PubMed Web of Science ®Google Scholar
• Arhan P, Devroede G, Jehannin B, et al. Segmental colonic transit time Dis Colon Rectum. Dis Colon Rectum. 1981;24(8):625–629. doi: 10.1007/BF02605761
   PubMed Web of Science ®Google Scholar
• Metcalf AM, Phillips SF, Zinsmeister AR, et al. Simplified assessment of segmental colonic transit. Gastroenterology. 1987;92(1):40–47. doi:10.1016/0016-5085(87)90837-7
   PubMed Web of Science ®Google Scholar
• Bouchoucha M, Devroede G, Arhan P, et al. What is the meaning of colorectal transit time measurement? Dis Colon Rectum. 1992;35(8):773–782. doi: 10.1007/BF02050328
   PubMed Web of Science ®Google Scholar
• Quitadamo P, Thapar N, Staiano A, et al. Effect of bowel cleansing on colonic transit time measurement in children with chronic constipation. J Pediatr. 2015;167(6):1440–1442 e1441. doi: 10.1016/j.jpeds.2015.09.035
   PubMed Web of Science ®Google Scholar
• Rybak A, Martinelli M, Thapar N, et al. Colonic function investigations in children: review by the ESPGHAN motility working group. J Pediatr Gastroenterol Nutr. 2022;74(5):681–692. doi: 10.1097/MPG.0000000000003429
   PubMed Web of Science ®Google Scholar
• Benninga MA, Buller HA, Tytgat GN, et al. Colonic transit time in constipated children: does pediatric slow-transit constipation exist? J Pediatr Gastroenterol Nutr. 1996;23(3):241–251. doi:10.1097/00005176-199610000-00007
   PubMed Web of Science ®Google Scholar
• de Lorijn F, van Wijk MP, Reitsma JB, et al. Prognosis of constipation: clinical factors and colonic transit time. Arch Dis Child. 2004;89(8):723–727. doi:10.1136/adc.2003.040220
   PubMed Web of Science ®Google Scholar
• Popescu M, Mutalib M. Bowel transit studies in children: evidence base, role and practicalities. Frontline Gastroenterol. 2022;13(2):152–159. doi:10.1136/flgastro-2020-101719
   PubMed Web of Science ®Google Scholar
• Wewer V, Strandberg C, Paerregaard A, et al. Abdominal ultrasonography in the diagnostic work-up in children with recurrent abdominal pain. Eur J Pediatr. 1997;156(10):787–788. doi:10.1007/s004310050713
   PubMed Web of Science ®Google Scholar
• Shanon A, Martin DJ, Feldman W. Ultrasonographic studies in the management of recurrent abdominal pain. Pediatrics. 1990;86(1):35–38. doi:10.1542/peds.86.1.35
   PubMed Web of Science ®Google Scholar
• van der Meer SB, Forget PP, Arends JW, et al. Diagnostic value of ultrasound in children with recurrent abdominal pain. Pediatr Radiol. 1990;20(7):501–503. doi:10.1007/BF02011375
   PubMed Web of Science ®Google Scholar
• Devanarayana NM, Rajindrajith S, Benninga MA. Abdominal migraine in children: association between gastric motility parameters and clinical characteristics. BMC Gastroenterol. 2016;16(1):26. doi: 10.1186/s12876-016-0435-2
   PubMedGoogle Scholar
• Devanarayana NM, Rajindrajith S, Rathnamalala N, et al. Delayed gastric emptying rates and impaired antral motility in children fulfilling Rome III criteria for functional abdominal pain. Neurogastroenterol Motil. 2012;24(5):420–425, e207. doi:10.1111/j.1365-2982.2011.01871.x
   PubMed Web of Science ®Google Scholar
• Devanarayana NM, de Silva DG, de Silva HJ. Gastric myoelectrical and motor abnormalities in children and adolescents with functional recurrent abdominal pain. J Gastroenterol Hepatol. 2008;23(11):1672–1677. doi:10.1111/j.1440-1746.2008.05529.x
   PubMed Web of Science ®Google Scholar
• Devanarayana NM, Rajindrajith S, Bandara C, et al. Ultrasonographic assessment of liquid gastric emptying and antral motility according to the subtypes of irritable bowel syndrome in children. J Pediatr Gastroenterol Nutr. 2013;56(4):443–448. doi:10.1097/MPG.0b013e31827f7a3d
   PubMed Web of Science ®Google Scholar
• Devanarayana NM, de Silva DGH, de Silva HJ. Recurrent abdominal pain syndrome in a cohort of Sri Lankan children and adolescents. J Trop Pediatr. 2008;54(3):178–183. doi:10.1093/tropej/fmm114
   PubMed Web of Science ®Google Scholar
• Devanarayana NM, Rajindrajith S, Perera MS, et al. Gastric emptying and antral motility parameters in children with functional dyspepsia: association with symptom severity. J Gastroenterol Hepatol. 2013;28(7):1161–1166. doi:10.1111/jgh.12205
   PubMed Web of Science ®Google Scholar
• Cucchiara S, Bortolotti M, Colombo C, et al. Abnormalities of gastrointestinal motility in children with nonulcer dyspepsia and in children with gastroesophageal reflux disease. Dig Dis Sci. 1991;36(8):1066–1073. doi: 10.1007/BF01297448
   PubMed Web of Science ®Google Scholar
• Hoffman I, Tack J. Assessment of gastric motor function in childhood functional dyspepsia and obesity. Neurogastroenterol Motil. 2012;24(2):108–112, e181. doi:10.1111/j.1365-2982.2011.01813.x
   PubMed Web of Science ®Google Scholar
• Gomes H, Hornoy P, Liehn JC. Ultrasonography and gastric emptying in children: validation of a sonographic method and determination of physiological and pathological patterns. Pediatr Radiol. 2003;33(8):522–529. doi:10.1007/s00247-003-0954-1
   PubMed Web of Science ®Google Scholar
• Camilleri M, Parkman HP, Shafi MA, et al. Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013;108(1):18–37; quiz 38. doi: 10.1038/ajg.2012.373
   PubMed Web of Science ®Google Scholar
• Kovacic K, Elfar W, Rosen JM, et al. Update on pediatric gastroparesis: a review of the published literature and recommendations for future research. Neurogastroenterol Motil. 2020;32(3):e13780. doi: 10.1111/nmo.13780
   PubMed Web of Science ®Google Scholar
• Klijn AJ, Asselman M, Vijverberg MA, et al. The diameter of the rectum on ultrasonography as a diagnostic tool for constipation in children with dysfunctional voiding. J Urol. 2004;172(5 Pt 1):1986–1988. doi:10.1097/01.ju.0000142686.09532.46
   PubMed Web of Science ®Google Scholar
• Singh SJ, Gibbons NJ, Vincent MV, et al. Use of pelvic ultrasound in the diagnosis of megarectum in children with constipation. J Pediatr Surg. 2005;40(12):1941–1944. doi:10.1016/j.jpedsurg.2005.08.012
   PubMed Web of Science ®Google Scholar
• Hamdy AM, Sakr HM, Boules IS, et al. The role of rectal ultrasound in children with functional constipation. J Paediatr Child Health. 2023;59(3):533–536. doi:10.1111/jpc.16344
   PubMed Web of Science ®Google Scholar
• Burgers R, de Jong TP, Benninga MA. Rectal examination in children: digital versus transabdominal ultrasound. J Urol. 2013;190(2):667–672. doi:10.1016/j.juro.2013.02.3201
   PubMed Web of Science ®Google Scholar
• Modin L, Dalby K, Walsted AM, et al. Transabdominal ultrasound measurement of rectal diameter is dependent on time to defecation in constipated children. J Paediatr Child Health. 2015;51(9):875–880. doi:10.1111/jpc.12881
   PubMed Web of Science ®Google Scholar
• Bijos A, Czerwionka-Szaflarska M, Mazur A, et al. The usefulness of ultrasound examination of the bowel as a method of assessment of functional chronic constipation in children. Pediatr Radiol. 2007;37(12):1247–1252. doi:10.1007/s00247-007-0659-y
   PubMed Web of Science ®Google Scholar
• Harris BR, Chinta SS, Colvin R, et al. Undifferentiated abdominal pain in children presenting to the pediatric emergency department. Clin Pediatr (Phila). 2019;58(11–12):1212–1223. doi:10.1177/0009922819867459
   PubMed Web of Science ®Google Scholar
• Khan HH, Subedi S, Kumar S, et al. The Pattern of CT scan use in the diagnosis of abdominal pain in children presenting to the emergency department of a tertiary community Hospital. Cureus. 2021;13(10):e19162. doi:10.7759/cureus.19162
   PubMed Web of Science ®Google Scholar
• Fahimi J, Herring A, Harries A, et al. Computed tomography use among children presenting to emergency departments with abdominal pain. Pediatrics. 2012;130(5):e1069–1075. doi:10.1542/peds.2012-0739
   PubMed Web of Science ®Google Scholar
• Bekkali NL, Hagebeuk EE, Bongers ME, et al. Magnetic resonance imaging of the lumbosacral spine in children with chronic constipation or non-retentive fecal incontinence: a prospective study. J Pediatr. 2010;156(3):461–465. doi: 10.1016/j.jpeds.2009.09.048
   PubMed Web of Science ®Google Scholar
• Rosen R, Buonomo C, Andrade R, et al. Incidence of spinal cord lesions in patients with intractable constipation. J Pediatr. 2004;145(3):409–411. doi:10.1016/j.jpeds.2004.06.026
   PubMed Web of Science ®Google Scholar
• Ringel Y. New directions in brain imaging research in functional gastrointestinal disorders. Dig Dis. 2006;24(3–4):278–285. doi:10.1159/000092881
   PubMed Web of Science ®Google Scholar
• Villringer A. Understanding functional neuroimaging methods based on neurovascular coupling. Adv Exp Med Biol. 1997;413:177–193.
   PubMed Web of Science ®Google Scholar
• Verne GN, Himes NC, Robinson ME, et al. Central representation of visceral and cutaneous hypersensitivity in the irritable bowel syndrome. Pain. 2003;103(1–2):99–110. doi: 10.1016/S0304-3959(02)00416-5
   PubMed Web of Science ®Google Scholar
• Ringel Y, Drossman DA, Leserman JL, et al. Effect of abuse history on pain reports and brain responses to aversive visceral stimulation: an FMRI study. Gastroenterology. 2008;134(2):396–404. doi: 10.1053/j.gastro.2007.11.011
   PubMed Web of Science ®Google Scholar
• Tillisch K, Mayer EA, Labus JS. Quantitative meta-analysis identifies brain regions activated during rectal distension in irritable bowel syndrome. Gastroenterology. 2011;140(1):91–100. doi:10.1053/j.gastro.2010.07.053
   PubMed Web of Science ®Google Scholar
• Hubbard CS, Becerra L, Heinz N, et al. Abdominal pain, the adolescent and altered brain structure and function. PLoS One. 2016;11(5):e0156545. doi: 10.1371/journal.pone.0156545
   PubMed Web of Science ®Google Scholar
• Menon V, Uddin LQ. Saliency, switching, attention and control: a network model of insula function. Brain Struct Funct. 2010;214(5–6):655–667. doi:10.1007/s00429-010-0262-0
   PubMed Web of Science ®Google Scholar
• Liu X, Silverman A, Kern M, et al. Excessive coupling of the salience network with intrinsic neurocognitive brain networks during rectal distension in adolescents with irritable bowel syndrome: a preliminary report. Neurogastroenterol Motil. 2016;28(1):43–53. doi: 10.1111/nmo.12695
   PubMed Web of Science ®Google Scholar
• Mugie SM, Koppen IJN, van den Berg MM, et al. Brain processing of rectal sensation in adolescents with functional defecation disorders and healthy controls. Neurogastroenterol Motil. 2018;30(3). doi: 10.1111/nmo.13228
   PubMed Web of Science ®Google Scholar
• Mayer EA, Labus JS, Tillisch K, et al. Towards a systems view of IBS. Nat Rev Gastroenterol Hepatol. 2015;12(10):592–605. doi: 10.1038/nrgastro.2015.121
   PubMed Web of Science ®Google Scholar
• Feinle C, Kunz P, Boesiger P, et al. Scintigraphic validation of a magnetic resonance imaging method to study gastric emptying of a solid meal in humans. Gut. 1999;44(1):106–111. doi:10.1136/gut.44.1.106
   PubMed Web of Science ®Google Scholar
• Ajaj W, Goehde SC, Papanikolaou N, et al. Real time high resolution magnetic resonance imaging for the assessment of gastric motility disorders. Gut. 2004;53(9):1256–1261. doi: 10.1136/gut.2003.038588
   PubMed Web of Science ®Google Scholar
• Menys A, Keszthelyi D, Fitzke H, et al. A magnetic resonance imaging study of gastric motor function in patients with dyspepsia associated with Ehlers-Danlos syndrome-Hypermobility type: a feasibility study. Neurogastroenterol Motil. 2017;29(9). doi: 10.1111/nmo.13090
   PubMed Web of Science ®Google Scholar
• Watanabe Y, Ikegami R, Osuka A. The usefulness of dynamically balanced FFE WATS-MR imaging with kinematic display for studying pediatric gastrointestinal disease. Pediatr Surg Int. 2005;21(11):868–872. doi:10.1007/s00383-005-1532-4
   PubMed Web of Science ®Google Scholar
• Ohkubo H, Kessoku T, Fuyuki A, et al. Assessment of small bowel motility in patients with chronic intestinal pseudo-obstruction using cine-MRI. Am J Gastroenterol. 2013;108(7):1130–1139. doi: 10.1038/ajg.2013.57
   PubMed Web of Science ®Google Scholar
• Menys A, Hoad C, Spiller R, et al. Spatio-temporal motility MRI analysis of the stomach and colon. Neurogastroenterol Motil. 2019;31(5):e13557. doi: 10.1111/nmo.13557
   PubMed Web of Science ®Google Scholar
• Vriesman MH, de Jonge CS, Kuizenga-Wessel S, et al. Simultaneous assessment of colon motility in children with functional constipation by cine-MRI and colonic manometry: a feasibility study. Eur Radiol Exp. 2021;5(1):8. doi: 10.1186/s41747-021-00205-5
   PubMedGoogle Scholar
• Mugie SM, Bates DG, Punati JB, et al. The value of fluoroscopic defecography in the diagnostic and therapeutic management of defecation disorders in children. Pediatr Radiol. 2015;45(2):173–180. doi:10.1007/s00247-014-3137-3
   PubMed Web of Science ®Google Scholar
• Kim K, Jeon HJ, Bae SH. Value of fluoroscopic defecography in constipated children with abnormal colon transit time test results. J Neurogastroenterol Motil. 2020;26(1):128–132. doi:10.5056/jnm18201
   PubMed Web of Science ®Google Scholar
• Zhang SC, Wang WL, Liu X. Defecography used as a screening entry for identifying evacuatory pelvic floor disorders in childhood constipation. Clin Imaging. 2014;38(2):115–121. doi:10.1016/j.clinimag.2013.11.010
   PubMed Web of Science ®Google Scholar
• Kanmaniraja D, Arif-Tiwari H, Palmer SL, et al. MR defecography review. Abdom Radiol (NY). 2021;46(4):1334–1350. doi: 10.1007/s00261-019-02228-4
   PubMed Web of Science ®Google Scholar
• Nothgi A, Hutchinson R, Kumar D, et al. Use of geometric center and parametric images in scintigraphic colonic transit studies. Gastroenterology. 1994;107(5):1270–1277. doi:10.1016/0016-5085(94)90527-4
   PubMed Web of Science ®Google Scholar
• Cook BJ, Lim E, Cook D, et al. Radionuclear transit to assess sites of delay in large bowel transit in children with chronic idiopathic constipation. J Pediatr Surg. 2005;40(3):478–483. doi: 10.1016/j.jpedsurg.2004.11.029
   PubMed Web of Science ®Google Scholar
• Yik YI, Cain TM, Tudball CF, et al. Nuclear transit studies of patients with intractable chronic constipation reveal a subgroup with rapid proximal colonic transit. J Pediatr Surg. 2011;46(7):1406–1411. doi:10.1016/j.jpedsurg.2011.02.049
   PubMed Web of Science ®Google Scholar
• Abell TL, Camilleri M, Donohoe K, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and motility Society and the Society of nuclear Medicine. Am J Gastroenterol. 2008;103(3):753–763. doi: 10.1111/j.1572-0241.2007.01636.x
   PubMed Web of Science ®Google Scholar
• Wolfson S, Wilhelm Z, Opekun AR, et al. Clinical characterization of pediatric gastroparesis using a four-hour gastric emptying scintigraphy standard. J Pediatr Gastroenterol Nutr. 2021;72(6):848–853. doi:10.1097/MPG.0000000000003089
   PubMed Web of Science ®Google Scholar
• Chogle A, Saps M. Gastroparesis in children: the benefit of conducting 4-hour scintigraphic gastric-emptying studies. J Pediatr Gastroenterol Nutr. 2013;56(4):439–442. doi:10.1097/MPG.0b013e31827a789c
   PubMed Web of Science ®Google Scholar
• Wong GK, Shulman RJ, Chumpitazi BP. Gastric emptying scintigraphy results in children are affected by age, anthropometric factors, and study duration. Neurogastroenterol Motil. 2015;27(3):356–362. doi:10.1111/nmo.12499
   PubMed Web of Science ®Google Scholar