Stern H P, Stroh S E, Fiedorek S C, Kelleher K, Mellon M W, Pope S K, Rayford P L
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA.
Pediatrics. 1995 Jul;96(1 Pt 1):111-7.
Abnormalities of hormones affecting gastrointestinal motility have been found in "functional" disorders of the gastrointestinal system in adults. One such disorder of childhood, encopresis, is frequently associated with constipation, the treatment of which often eliminates the soiling. We hypothesized that hormones affecting gastrointestinal motility were different between encopretic patients and matched controls.
Ten encopretic patients were matched by age, race, and sex with controls who had no history of encopresis or constipation. After an overnight fast, each child consumed a meal of Ensure, the amount of which was based on body weight. Plasma levels of gastrin, pancreatic polypeptide, cholecystokinin, motilin, thyroxine, estrogen, and insulin were measured 20 and 5 minutes before the meal, and 5, 10, 15, 30, 45, 60, 90, 120, 150, and 180 minutes after the meal.
Postprandial levels of pancreatic polypeptide remained consistently higher and peaked earlier (P < .05) for encopretic patients. The motilin response was lower (P < .03) for encopretic children than for controls.
We conclude that pancreatic polypeptide and motilin responses to a meal are different in encopretic children than in children in the control group. These gastrointestinal hormone findings may in part explain and/or be the result of the severe constipation that frequently underlies the fecal soiling found in these patients. These findings also suggest the motility of the stomach and small intestine may be abnormal in encopresis.
在成人胃肠道“功能性”疾病中发现了影响胃肠动力的激素异常。儿童的一种此类疾病——大便失禁，常与便秘相关，便秘的治疗往往能消除弄脏现象。我们推测大便失禁患者与匹配的对照组之间影响胃肠动力的激素有所不同。
10名大便失禁患者按年龄、种族和性别与无大便失禁或便秘病史的对照组进行匹配。禁食一夜后，每个孩子食用一顿安素餐，其用量根据体重而定。在进餐前20分钟和5分钟以及进餐后5、10、15、30、45、60、90、120、150和180分钟测量血浆胃泌素、胰多肽、胆囊收缩素、胃动素、甲状腺素、雌激素和胰岛素水平。
大便失禁患者餐后胰多肽水平持续较高且峰值出现更早（P < 0.05）。大便失禁儿童的胃动素反应低于对照组（P < 0.03）。
我们得出结论，大便失禁儿童与对照组儿童对进餐的胰多肽和胃动素反应不同。这些胃肠道激素的发现可能部分解释和/或导致这些患者中经常作为粪便弄脏基础的严重便秘。这些发现还表明大便失禁患者的胃和小肠动力可能异常。
