Colonic Transit Time in Chronic Constipated Patients

PURPOSE: In most instances, constipation is considered as idiopathic or functional. The total colonic transit time, traced by radio-opaque markers, makes possible the identification of the colon segment that has the motility alteration that causes constipation. We measured the total and segmental colonic transit time in children with chronic idiopathic constipation and compared the results with those without constipation to determine whether the classification of constipation according to colonic transit time is effective or not on management of functional constipation. METHODS: A study was performed on 15 children aged from 7 to 13, with functional chronic constipation and on 10 without constipation. In all of them the total and segmental colonic transit time were measured with radio-opaque markers. The children ingested 24 markers each on three successive days, and on the fourth day a plain abdominal radiograph was performed. RESULTS: In the nonconstipated children, the total colonic transit time(mean+/-SD) was 30.7+/-10.5 hours, in the right colon 4.7+/-3.3 hours, in the left colon 4.6+/-2.3 hours, and in the rectosigmoid 21.4+/-10.3 hours. In the constipated children, the total colonic transit time was 51.5+/-16.8 hours, in the right colon 13.1+/-6.8 hours, in the left colon 14.3+/-9.8 hours, and in the rectosigmoid 24.1+/-12.6 hours. There was a statistically significant difference(P<0.05) in the total colonic transit time and in both the right and left colon transit times between the constipation and the control group. CONCLUSION: The measurement of total and segmental colonic transit time is a simple method that allows one to distinguish constipation due to colonic dysfunction(right colon and left colon) from constipation due to distal obstruction(rectosigmoid).

Comparison of the Effectiveness of Phototherapy for Nonhemolytic Hyperbilirubinemia in Breast-fed and Formula-fed Infants

PURPOSE: This study was designed to evaluate the efficacy of phototherapy for nonhemolytic hyperbilirubinemia in breast-fed and formula-fed infants and infants receiving formula and breast milk. METHODS: Full-term healthy infants with nonhemolytic hyperbilirubinemia (bilirubin concentration > or =13.0 mg/dL) were treated with conventional phototherapy by using daylight fluorescent lamps. Three groups of infants were studied : group A, formula-fed infants; group B, breast-fed infants; group C, infants receiving formula and breast milk. All patterns of feeding started at birth. Phototherapy was terminated only when bilirubin concentration had decreased to less than 10.0 mg/dL. RESULTS: A total of 163 infants were studied. Phototherapy was highly effective in reducing the bilirubin concentration in all three groups, however, its efficacy of in group B was poorer compared with the other two groups. The duration of photopherapy and weight loss during phototherapy were not significantly different in the three groups. Decrease rates of bilirubin concentration during phototherapy in group A and C were significantly faster than that of group B. CONCLUSION: The response to phototherapy of group B infants was significantly slower than those of group A and C infants. The addition of formula to the feedings for totally breast-fed infants, without suspension of breast feeding, would enhance the efficacy of phototherapy and reduce exposure time.

The Optimum Dose of Oral Diazepam to Reduce Seizure Attack in Febrile Seizure Patients During Febrile Illness

PURPOSE: Febrile seizure is the most common type of seizure affecting 3-4% of children. The recurrence rate of febrile seizure is approximately 33%. About 16% of children with a febrile seizure during the febrile illness have a recurrent seizure attack within 24 hours. This study aimed to investigate the optimum dose of diazepam to reduce the recurrence of febrile seizures in children who have had a febrile seizure attack. METHODS: The children with febrile seizure who were admitted to the Maryknoll hospital for in vestigation and treatment were retrospectively reviewed. The study group compromised 306 children. The febrile seizure was defined as seizure attack with fever(above 38degreeC) without evidence of intracranial infection or defined cause in children aged 6 months to 5 years. The children were divided into four groups according to dose of diazepam. Group I, 72 patients, received no diazepam therapy. Group II, 78 patients, received oral diazepam in a dose of 0.1 mg/kg every eight hours during the febrile illness, Group III, 87 patients, 0.2 mg/kg, and Group IV, 69 patients, 0.3 mg/kg, respectively. RESULTS: The seizure attack rate and the duration of admission were reduced in both Group III and Group IV. However, there was no difference in the side effects of the diazepam between group III and IV. CONCLUSION: Oral diazepam in a dose of 0.2 mg/kg effectively decreases both the seizure attack rate and the duration of admission.