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Related Concept Videos

Gastrointestinal Motility Disorders01:20

Gastrointestinal Motility Disorders

Gastrointestinal or GI motility disorders are characterized by irregular gastrointestinal tract movements, disrupting food transit from the mouth to the anus. They are caused by damage or dysfunction in gut muscles or nerves. These disorders can cause symptoms such as severe constipation, diarrhea, abdominal pain, and swallowing difficulties. Disorders can affect any segment of the GI tract and range widely in severity, from common conditions like GERD to life-threatening conditions like...
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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Nerve Supply of the GI Tract

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A Quantitative Cell Migration Assay for Murine Enteric Neural Progenitors
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Mucosal nerve deficiency in chronic childhood constipation: a postmigration defect?

Gwen Wendelschafer-Crabb1, Vishala Neppalli, Jose Jessurun

  • 1Department of Neurology, University of Minnesota Medical School, Minneapolis, MN 55455, USA. crabb001@umn.edu

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Summary

Children with idiopathic chronic childhood constipation (ICCC) often have reduced rectal mucosal nerves, indicating autonomic dysfunction. This finding helps diagnose ICCC in children without Hirschsprung

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Area of Science:

  • Pediatric Gastroenterology
  • Neurogastroenterology
  • Autonomic Nervous System Research

Background:

  • Idiopathic chronic childhood constipation (ICCC) affects children resistant to standard treatments.
  • Distinguishing ICCC from Hirschsprung's disease (HSCR) relies on rectal biopsy findings.
  • Autonomic dysfunction is a potential underlying factor in ICCC.

Purpose of the Study:

  • To investigate potential autonomic dysfunction in children with ICCC.
  • To examine rectal mucosal nerves in ICCC patients.
  • To compare innervation in ICCC, HSCR, and non-constipated children.

Main Methods:

  • Rectal biopsy specimens from constipated children were analyzed.
  • Immunostaining and confocal microscopy were employed.
  • A computer-assisted neuron tracing technique quantified mucosal nerve density.

Main Results:

  • Zamboni-fixed specimens showed superior nerve staining compared to formalin-fixed.
  • Children with ICCC exhibited significantly reduced rectal mucosal nerve density.
  • Severe nerve deficiency was also noted in HSCR patients, even in ganglion-containing segments.

Conclusions:

  • Decreased rectal mucosal innervation is common in ICCC.
  • Reduced mucosal nerves may contribute to constipation by impairing reflexes and secretion.
  • Mucosal nerve density offers a diagnostic marker for ICCC, distinct from HSCR.
  • Neuron tracing validates as an objective method for assessing innervation.