{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:43:42Z","timestamp":1762325022538,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:00:00Z","timestamp":1622160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["II-LB-0814-20002"],"award-info":[{"award-number":["II-LB-0814-20002"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry Of Health, Civil Service Commission, Kuwait","award":["Ms Hayfa Sharif's PhD scholarship"],"award-info":[{"award-number":["Ms Hayfa Sharif's PhD scholarship"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Functional constipation in children is common. Management of this condition can be challenging and is often based on symptom reports. Increased, objective knowledge of colonic volume changes in constipation compared to health could provide additional information. However, very little data on paediatric colonic volume is available except from methods that are invasive or require unphysiological colonic preparations. Objectives: (1) To measure volumes of the undisturbed colon in children with functional constipation (FC) using magnetic resonance imaging (MRI) and provide initial normal range values for healthy controls, and (2) to investigate possible correlation of colonic volume with whole gut transit time (WGTT). Methods: Total and regional (ascending, transverse, descending, sigmoid, and rectum) colon volumes were measured from MRI images of 35 participants aged 7\u201318 years (16 with FC and 19 healthy controls), and corrected for body surface area. Linear regression was used to explore the relationship between total colon volume and WGTT. Results: Total colonic volume was significantly higher, with a median (interquartile range) of 309 mL (243\u2013384 mL) for the FC group than for the healthy controls of 227 mL (180\u2013263 mL). The largest increase between patients and controls was in the sigmoid colon\u2013rectum region. In a linear regression model, there was a positive significant correlation between total colonic volume and WGTT (R = 0.56, p = 0.0005). Conclusions: This initial study shows increased volumes of the colon in children with FC, in a physiological state, without use of any bowel preparation. Increased knowledge of colonic morphology may improve understanding of FC in this age group and help to direct treatment.<\/jats:p>","DOI":"10.3390\/diagnostics11060974","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T11:33:20Z","timestamp":1622201600000},"page":"974","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Colonic Volume Changes in Paediatric Constipation Compared to Normal Values Measured Using MRI"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0854-1242","authenticated-orcid":false,"given":"Hayfa","family":"Sharif","sequence":"first","affiliation":[{"name":"Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK"},{"name":"Ministry of Health, Civil Service Commission, Amiri Hospital, Kuwait City 15300, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline L.","family":"Hoad","sequence":"additional","affiliation":[{"name":"Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2456-3222","authenticated-orcid":false,"given":"Nichola","family":"Abrehart","sequence":"additional","affiliation":[{"name":"Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Penny A.","family":"Gowland","sequence":"additional","affiliation":[{"name":"Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6371-4500","authenticated-orcid":false,"given":"Robin C.","family":"Spiller","sequence":"additional","affiliation":[{"name":"Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sian","family":"Kirkham","sequence":"additional","affiliation":[{"name":"Nottingham Children\u2019s Hospital, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabarinathan","family":"Loganathan","sequence":"additional","affiliation":[{"name":"Nottingham Children\u2019s Hospital, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michalis","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Nottingham Children\u2019s Hospital, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc A.","family":"Benninga","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Emma Children\u2019s Hospital, Amsterdam UMC, 9, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3376-3795","authenticated-orcid":false,"given":"David","family":"Devadason","sequence":"additional","affiliation":[{"name":"Nottingham Children\u2019s Hospital, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9092-4300","authenticated-orcid":false,"given":"Luca","family":"Marciani","sequence":"additional","affiliation":[{"name":"Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.jpeds.2018.02.029","article-title":"Prevalence of functional defecation disorders in children: A systematic review and meta-analysis","volume":"198","author":"Koppen","year":"2018","journal-title":"J. Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1002\/bjs.9111","article-title":"Clinical and psychosocial functioning in adolescents and young adults with anorectal malformations and chronic idiopathic constipation","volume":"100","author":"Athanasakos","year":"2013","journal-title":"Br. J. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.jpedsurg.2004.02.003","article-title":"Chronic constipation: No longer stuck! Characterization of colonic dysmotility as a new disorder in children","volume":"39","author":"Hutson","year":"2004","journal-title":"J. Pediatr. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00383-009-2363-5","article-title":"Slow-transit constipation in children: Our experience","volume":"25","author":"Hutson","year":"2009","journal-title":"Pediatr. Surg. Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1053\/j.gastro.2016.02.015","article-title":"Childhood functional gastrointestinal disorders: Child\/adolescent","volume":"150","author":"Hyams","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1053\/j.gastro.2016.02.032","article-title":"Functional gastrointestinal disorders: History, pathophysiology, clinical features, and rome iv","volume":"150","author":"Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1002\/ca.22941","article-title":"The length of the large intestine in children determined by computed tomography scan","volume":"30","author":"Mirjalili","year":"2017","journal-title":"Clin. Anat."},{"key":"ref_8","first-page":"7","article-title":"Anatomy of the rectum and anal canal","volume":"38","author":"Mahadevan","year":"2020","journal-title":"Surgery"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1136\/bmj.2.4950.1243","article-title":"Intestinal length in man","volume":"2","author":"Underhill","year":"1955","journal-title":"Br. Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1007\/s00276-002-0057-y","article-title":"Anatomical study of the length of the human intestine","volume":"24","author":"Hounnou","year":"2002","journal-title":"Surg. Radiol. Anat."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/BF00346222","article-title":"A peroperative comparison of western and oriental colonic anatomy and mesenteric attachments","volume":"10","author":"Saunders","year":"1995","journal-title":"Int. J. Colorectal Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/BF01794949","article-title":"Analysis of length and surface area of each segment of the large intestine according to age, sex and physique","volume":"14","author":"Sadahiro","year":"1992","journal-title":"Surg. Radiol. Anat."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Sharif, H., Devadason, D., Abrehart, N., Stevenson, R., and Marciani, L. (2019). Imaging measurement of whole gut transit time in paediatric and adult functional gastrointestinal disorders: A systematic review and narrative synthesis. Diagnostics, 9.","DOI":"10.3390\/diagnostics9040221"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Orellana, B., Monclus, E., Brunet, P., Navazo, I., Bendezu, A., and Azpiroz, F. (2020). A scalable approach to T2-MRI colon segmentation. Med. Image Anal., 63.","DOI":"10.1016\/j.media.2020.101697"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1111\/nmo.12673","article-title":"Quantification and variability in colonic volume with anovel magnetic resonance imaging method","volume":"27","author":"Nilsson","year":"2015","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/nmo.12243","article-title":"Fasting and postprandial volumes of the undisturbed colon: Normal values and changes in diarrhea-predominant irritable bowel syndrome measured using serial MRI","volume":"26","author":"Pritchard","year":"2014","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e13400","DOI":"10.1111\/nmo.13400","article-title":"Demonstration of differences in colonic volumes, transit, chyme consistency, and response to psyllium between healthy and constipated subjects using magnetic resonance imaging","volume":"30","author":"Major","year":"2018","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1111\/apt.15127","article-title":"Mechanisms underlying effects of kiwifruit on intestinal function shown by MRI in healthy volunteers","volume":"49","author":"Dellschaft","year":"2019","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1111\/nmo.12403","article-title":"Stimulation of colonic motility by oral PEG electrolyte bowel preparation assessed by MRI: Comparison of split vs single dose","volume":"26","author":"Marciani","year":"2014","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1111\/nmo.12784","article-title":"Colonic response to laxative ingestion as assessed by MRI differs in constipated irritable bowel syndrome compared to functional constipation","volume":"28","author":"Lam","year":"2016","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1038\/ajg.2016.538","article-title":"Distinct abnormalities of small bowel and regional colonic volumes in subtypes of irritable bowel syndrome revealed by MRI","volume":"112","author":"Lam","year":"2017","journal-title":"Am. J. Gastroenterol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e12930","DOI":"10.1111\/nmo.12930","article-title":"Colonic content: Effect of diet, meals, and defecation","volume":"29","author":"Bendezu","year":"2017","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1136\/adc.75.1.36","article-title":"Diagnostic dilemmas and results of treatment for chronic constipation","volume":"75","author":"KeuzenkampJansen","year":"1996","journal-title":"Arch. Dis. Child."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1097\/MPG.0000000000002910","article-title":"Feasibility study of a new magnetic resonance imaging mini-capsule device to measure whole gut transit time in paediatric constipation","volume":"71","author":"Sharif","year":"2020","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1002\/mrm.22578","article-title":"Dual-echo Dixon imaging with flexible choice of echo times","volume":"65","author":"Eggers","year":"2011","journal-title":"Magn. Reson. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ng, C., Dellschaft, N.S., Hoad, C.L., Marciani, L., Ban, L., Prayle, A.P., Barr, H.L., Jaudszus, A., Mainz, J.G., and Spiller, R.C. (2021). Postprandial changes in gastrointestinal function and transit in cystic fibrosis assessed by Magnetic Resonance Imaging. J. Cyst. Fibros., in press.","DOI":"10.1101\/2020.02.19.20022020"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1111\/j.1651-2227.2011.02580.x","article-title":"Estimation of body surface area in various childhood ages-validation of the Mosteller formula","volume":"101","author":"Lindemalm","year":"2012","journal-title":"Acta Paediatr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/S0016-5085(73)80125-8","article-title":"Colonic absorption in idiopathic constipation","volume":"64","author":"Devroede","year":"1973","journal-title":"Gastroenterology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"277","DOI":"10.3164\/jcbn.17-104","article-title":"Assessment of colonic contents in patients with chronic constipation using MRI","volume":"62","author":"Inoh","year":"2018","journal-title":"J. Clin. Biochem. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1053\/j.gastro.2015.10.005","article-title":"Relationship between microbiota of the colonic mucosa vs feces and symptoms, colonic transit, and methane production in female patients with chronic constipation","volume":"150","author":"Parthasarathy","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1208\/s12249-015-0350-9","article-title":"Colon-targeted oral drug delivery systems: Design trends and approaches","volume":"16","author":"Amidon","year":"2015","journal-title":"AAPS PharmSciTech"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/6\/974\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:09:29Z","timestamp":1760162969000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/6\/974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,28]]},"references-count":31,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["diagnostics11060974"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11060974","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2021,5,28]]}}}