[tri-med] Re: FYI - Slow transit constipation in children

this is basically "it is soft enough they just cant push it out"????
geez this is kam.  they should try smooth move...works for kam.  this goes
with the internal low tone and i think that might be related to kam's gi
bleed also.
jude, mom to derek-15, kelsey-13,  kameron-4-full t18
golden, colorado  usa
----- Original Message -----
From: "Karen Schuler" <karens@xxxxxxxxxxxxxxxx>
To: "Tri-med" <Tri-Med@xxxxxxxxxxxxx>
Sent: Friday, November 30, 2001 4:24 PM
Subject: [tri-med] FYI - Slow transit constipation in children


>
> I am forwarding this article or URL for your information (FYI) as I
believe
> it may be of interest and is from a reliable source. As always, check the
> information with your own doctor or health care professional before
starting
> or changing any treatments.
>
>
http://www.blackwell-synergy.com/Journals/content/abstracts/jpc/2001/37/5/ab
stract_jpc692.asp?journal=jpc&issueid=7517&artid=137316&
> cid=jpc.2001.5&ftype=abstracts
>
> Journal of Paediatrics and Child Health 37 (5), 426-430
> © Royal Australasian College of Physicians
>
> Slow transit constipation in children
> JM Hutson, J McNamara, S Gibb and Y-M Shin
>
> Departments of General Surgery and General Paediatrics, Royal Children's
Hospital and, Murdoch Children's Research Institute,
> Parkville, Victoria, Australia
>
> Abstract: Patients with chronic constipation that fails to respond to
treatment remain a challenge for paediatricians and surgeons.
> Ongoing work in our institution suggests that a number of children with
intractable symptoms have slow transit constipation, which
> has only been described recently in paediatrics. Common features of slow
transit are: delayed passage of the first meconium stool
> beyond 24 h of age, symptoms of severe constipation within a year, or
treatment-resistant 'encopresis' at 2-3 years, soft stools
> despite infrequent bowel actions, and delay in colonic transit on a
transit study. A proportion of children with slow transit
> constipation have an abnormality of intestinal innervation associated with
the dysfunctional colonic motility, recognized as
> intestinal neuronal dysplasia (IND). Intestinal neuronal dysplasia type B,
the most common variant of IND, is defined on rectal
> biopsy by hyperplasia of the submucosal plexus. On laparoscopic colon
muscle biopsy, many specimens show reduced numbers of
> excitatory substance P-immunoreactive nerve fibres in the circular muscle.
Functional markers of the nerves allow new diagnostic
> criteria to be developed which may also allow a more rational approach to
treatment. The aetiology remains obscure and the optimal
> management poorly defined, although subtotal colectomy, proximal colostomy
or appendicostomy (for antegrade enemas) have been tried.
> Once the anatomy and physiology of the colon in children with slow colonic
transit is better understood, we will have defined not
> only a new form of constipation, but also will be able to consider new
therapies.
>
> Keywords: constipation; encopresis; intestinal neuronal dysplasia;
substance P.
>
>
> --------------------------------------------------------------------------
------
>
> Correspondence: Professor JM Hutson Department of General Surgery, Royal
Children's Hospital, Flemington Road, Parkville 3052,
> Victoria, Australia. Fax: +61 3 9345 6668; email:
hutsonj@xxxxxxxxxxxxxxxxxxxxxxxxxx
>
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