F Douglas Stephens Surgical Research and Gut Motility Laboratories, Murdoch Children's Research Institute, Melbourne, Australia.
J Pediatr Surg. 2011 Jul;46(7):1406-11. doi: 10.1016/j.jpedsurg.2011.02.049.
AIMS/BACKGROUND: Nuclear transit studies (NTS) allow us to follow transit through the stomach and the small and large intestines. We identified children with chronic constipation with rapid proximal colonic transit and characterized their clinical features.
We reviewed NTS from 1998 to 2009 to identify patients with chronic constipation and rapid proximal colonic transit, defined as greater than 25% of tracer beyond hepatic flexure at 6 hour and/or greater than 25% of tracer beyond end of descending colon at 24 hour. This was correlated with clinical symptoms and outcome from patient records.
Five hundred twenty children with chronic constipation underwent investigation by NTS, and 64 (12%) were identified with rapid proximal colonic transit. The clinical history, symptoms, and outcome in 55 of 64 available for analysis frequently showed family history of allergy (10.9%) and symptoms associated with food allergy/intolerance: abdominal pain (80%), anal fissure (27.3%), and other allergic symptoms (43.6%). Eighteen children were treated with dietary exclusion, with resolution of symptoms in 9 (50%).
Some children with intractable chronic constipation have rapid proximal colonic transit, have symptoms consistent with possible food allergy/intolerance, and may respond to dietary exclusion. The NTS can identify these patients with rapid proximal transit that may be secondary to food intolerance.
目的/背景：核转运研究（NTS）使我们能够追踪胃和小肠及大肠的转运情况。我们发现部分慢性便秘患儿近端结肠转运较快，并对其临床特征进行了描述。
我们回顾了 1998 年至 2009 年的 NTS 检查结果，以确定慢性便秘且近端结肠转运较快的患者，定义为 6 小时时示踪剂超过肝曲 25%，或 24 小时时示踪剂超过降结肠末端 25%。将这些结果与患者的临床症状和治疗结果进行相关性分析。
520 名慢性便秘患儿接受了 NTS 检查，其中 64 名（12%）被诊断为近端结肠转运较快。对 64 名可进行分析的患者中的 55 名的临床病史、症状和治疗结果进行了分析，发现这些患者常存在过敏家族史（10.9%）和与食物过敏/不耐受相关的症状：腹痛（80%）、肛裂（27.3%）和其他过敏症状（43.6%）。18 名患儿接受了饮食排除疗法，其中 9 名（50%）症状得到缓解。
部分难治性慢性便秘患儿存在近端结肠转运较快的情况，伴有可能的食物过敏/不耐受的症状，且可能对饮食排除疗法有反应。NTS 可识别这些可能因食物不耐受而导致近端转运较快的患者。
