The nervous system and gastrointestinal function
Humans; Brain/physiology; Central Nervous System/physiology; Gastrointestinal Motility/physiology; Gastrointestinal Tract/anatomy & histology/physiology; Intestinal Mucosa/physiology; Pain/physiopathology; Parasympathetic Nervous System/physiology; Sympathetic Nervous System/physiology
The enteric nervous system is an integrative brain with collection of neurons in the gastrointestinal tract which is capable of functioning independently of the central nervous system (CNS). The enteric nervous system modulates motility, secretions, microcirculation, immune and inflammatory responses of the gastrointestinal tract. Dysphagia, feeding intolerance, gastroesophageal reflux, abdominal pain, and constipation are few of the medical problems frequently encountered in children with developmental disabilities. Alteration in bowel motility have been described in most of these disorders and can results from a primary defect in the enteric neurons or central modulation. The development and physiology of the enteric nervous system is discussed along with the basic mechanisms involved in controlling various functions of the gastrointestinal tract. The intestinal motility, neurogastric reflexes, and brain perception of visceral hyperalgesia are also discussed. This will help better understand the pathophysiology of these disorders in children with developmental disabilities.
2008
Altaf MA; Sood MR
Developmental Disabilities Research Reviews
2008
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1002/ddrr.15" target="_blank" rel="noreferrer">10.1002/ddrr.15</a>
Enteric nervous system and developmental abnormalities in childhood
Child; Humans; Animals; Gastrointestinal Motility/physiology; Neurons/physiology; Chromosome Aberrations; Ganglion Cysts/embryology; Gastrointestinal Tract/innervation; Glial Cell Line-Derived Neurotrophic Factors/physiology; Hirschsprung Disease/physiopathology; Nervous System Malformations/embryology/physiopathology; Neural Crest/embryology; Neurotransmitter Agents/physiology
ENS consists of a complex network of neurons, organised in several plexuses, which interact by means of numerous neurotransmitters. It is capable of modulating the intestinal motility, exocrine and endocrine secretions, microcirculation and immune and inflammatory responses within the gastrointestinal tract, independent of the central nervous system. Though the embryological development of various plexuses are completed by mid-way of gestation, the maturation of neurons and nerve plexuses appear to continue well after birth. Therefore, any histological or functional abnormalities related to the gastrointestinal function must be investigated with the ongoing maturational processes in mind.
2006
Paran TS; Rolle U; Puri P
Pediatric Surgery International
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1007/s00383-006-1782-9" target="_blank" rel="noreferrer">10.1007/s00383-006-1782-9</a>
Use of colonic manometry to differentiate causes of intractable constipation in children
Child; Female; Humans; Male; Food; Preschool; Q3 Literature Search; Gastrointestinal Motility/physiology; Colon/physiopathology; Colonic Diseases/complications/diagnosis; Constipation/etiology/psychology; Manometry; Nervous System Diseases/complications/diagnosis
We evaluated colon manometry as a means of differentiating causes of intractable constipation in children. We studied pressure changes in the transverse, descending, and rectosigmoid colons of 23 children with intractable constipation. All patients had a history of less than one bowel movement per week for longer than 2 years without resolution after conventional medical management. The possibility of Hirschsprung disease was excluded in all. On the basis of pathologic and manometric studies of the upper gastrointestinal tract, 10 patients had a diagnosis of gastrointestinal neuropathy and two had a diagnosis of myopathy. The other 11 patients had functional fecal retention; this diagnosis was based on history and outcome of therapy. On the day of study we used endoscopy to place a manometry catheter into the transverse colon and recorded intraluminal pressure for longer than 4 hours. After obtaining a baseline recording, we gave the patient a meal to assess gastrocolonic response. Colonic contractions were recorded in 21 of 23 children. Children with functional fecal retention could be differentiated from those with neuropathy by examination of the postprandial record. After a meal children with functional fecal retention had (1) an increase in motility index (3.4 +/- 0.5 while fasting vs 9.1 +/- 1.3 postprandially; p less than 0.001), and (2) at least one high-amplitude propagated contraction (in 10 of 11 children). The patients with neuropathy had no high-amplitude propagated contractions (p less than 0.001 vs group with functional fecal retention) and motility index in these children did not increase significantly after a meal (2.7 +/- 1.0 while fasting vs 2.9 +/- 1.3 postprandially). The two children with hollow visceral myopathy had no contractions. We conclude that in children with severe chronic constipation the colonic results of manometry differentiate patients with functional fecal retention from those with neuropathy or myopathy of the colon.
1992
Di Lorenzo C; Flores AF; Reddy SN; Hyman PE
The Journal Of Pediatrics
1992
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/s0022-3476(05)80229-x" target="_blank" rel="noreferrer">10.1016/s0022-3476(05)80229-x</a>