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Related Experiment Videos

Slow-transit constipation in childhood.

J M Wheatley1, J M Hutson, C W Chow

  • 1Royal Children's Hospital Research Institute, and the Department of Pathology, Royal Children's Hospital, Melbourne, Australia.

Journal of Pediatric Surgery
|June 8, 1999
PubMed
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Children with severe constipation often show early onset and delayed colonic transit. This is linked to a deficiency in substance P (SP) immunoreactivity, suggesting it as a marker for this condition.

Area of Science:

  • Pediatric Gastroenterology
  • Neurogastroenterology
  • Histopathology

Background:

  • Intestinal neuronal dysplasia (IND) is a debated cause of severe chronic constipation in children.
  • A subset of children with severe constipation exhibits reduced substance P (SP) immunoreactivity in colonic nerve fibers.

Purpose of the Study:

  • To investigate the correlation between SP deficiency in colonic nerve fibers and clinical features of severe constipation in children.
  • To assess the utility of SP immunoreactivity as a diagnostic marker for pediatric constipation.

Main Methods:

  • Clinical assessment via questionnaires and nuclear transit studies were performed on over 100 children with intractable constipation.
  • Laparoscopic seromuscular colonic biopsies were analyzed using immunofluorescence for SP and vasoactive intestinal peptide (VIP).

Related Experiment Videos

  • Histological examination for heterotopic or hypoplastic ganglia was also conducted.

    • Main Results:

    • 63% of children experienced constipation symptoms by age 1, with over 30% having delayed meconium passage.
    • Over 80% demonstrated significantly delayed colonic transit.
    • Approximately 80% of those with delayed transit showed reduced SP immunoreactivity in myenteric axons; 6% had abnormal ganglion development.

    Conclusions:

    • Early onset and delayed colonic transit in children with intractable constipation correlate with SP deficiency in myenteric axons.
    • Reduced SP immunoreactivity may serve as a histological marker for severe pediatric constipation.
    • Defective excitatory neuromuscular transmission is proposed as the underlying cause of slow colonic transit.