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Related Experiment Videos

Slow transit constipation in children.

J M Hutson1, J McNamara, S Gibb

  • 1Department of General Surgery and General Paediatrics, Royal Children's Hospital and, Murdoch Children's Research Institute, Parkville, Victoria, Australia. hutsonj@cryptic.rch.unimelb.edu.au

Journal of Paediatrics and Child Health
|March 12, 2002
PubMed
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Pediatric slow transit constipation, a recently described condition, presents challenges in treatment-resistant cases. Identifying intestinal neuronal dysplasia may lead to new diagnostic criteria and therapies for this severe constipation.

Area of Science:

  • Pediatric Gastroenterology
  • Colorectal Surgery
  • Neurogastroenterology

Background:

  • Chronic constipation in children unresponsive to treatment poses a significant clinical challenge.
  • Slow transit constipation (STC) is a recently identified condition in pediatrics characterized by delayed colonic transit.
  • A subset of children with STC exhibit intestinal neuronal dysplasia (IND), an innervation abnormality linked to colonic dysfunction.

Purpose of the Study:

  • To describe the clinical features and diagnostic findings of slow transit constipation in children.
  • To explore the association between intestinal neuronal dysplasia and slow transit constipation.
  • To highlight the need for improved understanding and management strategies for pediatric STC.

Main Methods:

  • Review of clinical features in children with intractable constipation.

Related Experiment Videos

  • Assessment of colonic transit using transit studies.
  • Histopathological examination of rectal biopsies for intestinal neuronal dysplasia (IND) and colon muscle biopsies for nerve fiber analysis.

    • Main Results:

    • Common STC features include delayed meconium passage, early-onset severe constipation, or treatment-resistant encopresis.
    • Intestinal neuronal dysplasia type B, characterized by submucosal plexus hyperplasia, is identified in a proportion of STC patients.
    • Reduced substance P-immunoreactive nerve fibers in the circular muscle were observed in colon biopsies.

    Conclusions:

    • Slow transit constipation represents a distinct entity in pediatric functional bowel disorders.
    • Intestinal neuronal dysplasia is associated with colonic motility dysfunction in pediatric STC.
    • Further research into the pathophysiology and neurobiology of STC is crucial for developing targeted therapies.