A new study published in Acta Gastoenterologica Belgica analyzed the predictive value of colon transit time (CTT) and anorectal manometry (ARM) in children with spina bifida (SB) in achieving spontaneous fecal continence. This was a prospective study, wherein 22 children with spina bifida (2.5-7 years old) who were followed at a University Hospital underwent CTT and/or ARM before starting bowel management. These children participated in a standardized questionnaire about the presence of constipation and fecal incontinence. CTT was measured using a 6-day pellet abdominal X-ray method. ARM was performed in non-sedated children using a latex-free catheter. All children underwent a CTT study; additionally, 77% agreed to ARM. The results showed that 45.5% patients were constipated; 22.7% acquired continence, spontaneously; 45.5% became pseudocontinent with bowel management; and the others remained incontinent. It was noted that SB patients had a significantly prolonged CTT compared to healthy controls. Meanwhile, none of the patients with abnormal CTT study developed fecal continence spontaneously, irrespective of the ARM result. Furthermore, out of the 10 patients with normal CTT study, seven agreed to ARM. All four children with normal resting pressure gained continence spontaneously, whereas the remaining three with abnormally low resting pressure remained incontinent. Hence, the results confirmed the predictive value of normal CTT and normal resting pressure, in the evolution towards spontaneous fecal continence. Therefore, if CTT is abnormal, irrespective of the ARM bowel management will be necessary to obtain pseudo-continence. In such cases, ARM is not a designated examination.