Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Esophageal Motility in Children With Hirschsprung's Disease

Esophageal Motility in Children With Hirschsprung's Disease Abstract • Esophageal motility was studied in 12 children with Hirschsprung's disease to see if extracolonic motor dysfunction was present in this disorder. Manometric tracings were compared with those from eight children with idiopathic megacolon and from 10 children without esophageal disease or constipation. Amplitude of esophageal contraction waves was significantly higher in children with Hirschsprung's disease than in the other two groups. Swallows that were followed by simultaneous contractions or double-peaked waves were also more common in the group with Hirschsprung's disease (subjects with Hirschsprung's disease, subjects with megacolon, and controls: 57%, 10%, and 8%, respectively). Lower esophageal sphincter characteristics did not differ among the three groups. The increase in simultaneous contractions and double-peaked waves persisted in those children who were reexamined following surgery for Hirschsprung's disease, whereas wave amplitudes fell to a level similar to that observed in the other groups. These data suggest that gastrointestinal motor dysfunction in persons with Hirschsprung's disease is not restricted to the colon, and that some of the observed abnormalities in esophageal motility do not reflect nonspecific responses to megacolon or colonic obstruction. (AJDC. 1991;145:310-313) References 1. Perman JA. The gastrointestinal tract: clinical presentation . In: Rudolph AM, ed. Pediatrics . East Norwalk, Conn: Appleton & Lange; 1987:900-901. 2. Behrman RE, Vanghan VC. Nelson Textbook of Pediatrics . Philadelphia, Pa: WB Saunders Co; 1987:783-785. 3. Cucchiara S, Staiano A, Di Lorenzo C, et al. Esophageal motor abnormalities in children with gastroesophageal reflux and peptic esophagitis . J Pediatr. 1986;108:907-910.Crossref 4. Clouse RE, Staiano A. Contraction abnormalities of the esophageal body in patients referred for manometry: a new approach to manometric classification . Dig Dis Sci. 1983;28:784-791.Crossref 5. Arhan P, Devroede G, Davis K, et al. Viscoelastic properties of the rectal wall in Hirschsprung's disease . J Clin Invest. 1978;62:82-86.Crossref 6. Stone WD, Hendrix TR, Schuster MM. Aganglionosis of the entire colon in an adolescent . Gastroenterology . 1965;48:636-641. 7. Diamant NE. Physiology of the esophagus . In: Sleisenger MH, Fordtran JS, eds. Gastrointestinal Disease: Pathophysiology, Diagnosis, and Management . 4th ed. Philadelphia, Pa: WB Saunders Co; 1989:548-557. 8. Senyuz OF, Danismend N, Erdogan E, Ozbay G, Buyukunal C. Total intestinal aganglionosis with involvement of the stomach . Pediatr Surg Int. 1988;3:74-75.Crossref 9. Passarge E. The genetics of Hirschsprung's disease: evidence for heterogeneous etiology and a study of sixty-three families . N Engl J Med. 1967;276:138-143.Crossref 10. Christensen J. Motility of the colon . In: Johnson LR, Christensen J, eds. Physiology of the Gastrointestinal Tract . New York, NY: Raven Press; 1987:685-686. 11. Kubota M, Ito Y, Ikeda K. Membrane properties and innervation of smooth muscle cells in Hirschsprung's disease . Am J Physiol . 1983;244:G406-G415. 12. Reynolds JC, Ouyang A, Lee CA, Baker L, Sunshine AG, Cohen S. Chronic severe constipation: prospective motility studies in 25 consecutive patients . Gastroenterology . 1987;92:414-420. 13. Leon SH, Krishnamurthy S, Schuffler MD. Subtotal colectomy for severe idiopathic constipation: a follow-up study of 13 patients . Dig Dis Sci. 1987;32:1249-1254.Crossref 14. Krishnamurthy S, Schuffler MD, Rohmann CA, Pope CE. Severe idiopathic constipation is associated with a distinctive abnormality of the colonic myenteric plexus . Gastroenterology . 1985;8:26-34.Crossref 15. Meunier P, Louis D, DeBeaujeu MJ. Physiologic investigation of primary chronic constipation in children: comparision with the barium enema study . Gastroenterology . 1984;87:1351-1357. 16. Loening-Beucke V. Abnormal rectoanal function in children recovered from chronic constipation and encopresis . Gastroenterology . 1986;87:1233-1241. 17. Abrahamian PP, Lloyd Still JD. Chronic constipation in childhood: a longitudinal study of 186 patients . J Pediatr Gastroenterol Nutr. 1984;3:460-467.Crossref 18. Swenson O. Sherman JO, Fisher JH. Diagnosis of congenital megacolon: an analysis of 501 patients . J Pediatr Surg. 1973;8:587-591.Crossref 19. Tunnessen WW. Signs and Symptoms in Pediatrics . 2nd ed. Philadelphia, Pa: JB Lippincott; 1988. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Loading next page...
 
/lp/american-medical-association/esophageal-motility-in-children-with-hirschsprung-s-disease-KMfShbibgn
Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1991.02160030078026
Publisher site
See Article on Publisher Site

Abstract

Abstract • Esophageal motility was studied in 12 children with Hirschsprung's disease to see if extracolonic motor dysfunction was present in this disorder. Manometric tracings were compared with those from eight children with idiopathic megacolon and from 10 children without esophageal disease or constipation. Amplitude of esophageal contraction waves was significantly higher in children with Hirschsprung's disease than in the other two groups. Swallows that were followed by simultaneous contractions or double-peaked waves were also more common in the group with Hirschsprung's disease (subjects with Hirschsprung's disease, subjects with megacolon, and controls: 57%, 10%, and 8%, respectively). Lower esophageal sphincter characteristics did not differ among the three groups. The increase in simultaneous contractions and double-peaked waves persisted in those children who were reexamined following surgery for Hirschsprung's disease, whereas wave amplitudes fell to a level similar to that observed in the other groups. These data suggest that gastrointestinal motor dysfunction in persons with Hirschsprung's disease is not restricted to the colon, and that some of the observed abnormalities in esophageal motility do not reflect nonspecific responses to megacolon or colonic obstruction. (AJDC. 1991;145:310-313) References 1. Perman JA. The gastrointestinal tract: clinical presentation . In: Rudolph AM, ed. Pediatrics . East Norwalk, Conn: Appleton & Lange; 1987:900-901. 2. Behrman RE, Vanghan VC. Nelson Textbook of Pediatrics . Philadelphia, Pa: WB Saunders Co; 1987:783-785. 3. Cucchiara S, Staiano A, Di Lorenzo C, et al. Esophageal motor abnormalities in children with gastroesophageal reflux and peptic esophagitis . J Pediatr. 1986;108:907-910.Crossref 4. Clouse RE, Staiano A. Contraction abnormalities of the esophageal body in patients referred for manometry: a new approach to manometric classification . Dig Dis Sci. 1983;28:784-791.Crossref 5. Arhan P, Devroede G, Davis K, et al. Viscoelastic properties of the rectal wall in Hirschsprung's disease . J Clin Invest. 1978;62:82-86.Crossref 6. Stone WD, Hendrix TR, Schuster MM. Aganglionosis of the entire colon in an adolescent . Gastroenterology . 1965;48:636-641. 7. Diamant NE. Physiology of the esophagus . In: Sleisenger MH, Fordtran JS, eds. Gastrointestinal Disease: Pathophysiology, Diagnosis, and Management . 4th ed. Philadelphia, Pa: WB Saunders Co; 1989:548-557. 8. Senyuz OF, Danismend N, Erdogan E, Ozbay G, Buyukunal C. Total intestinal aganglionosis with involvement of the stomach . Pediatr Surg Int. 1988;3:74-75.Crossref 9. Passarge E. The genetics of Hirschsprung's disease: evidence for heterogeneous etiology and a study of sixty-three families . N Engl J Med. 1967;276:138-143.Crossref 10. Christensen J. Motility of the colon . In: Johnson LR, Christensen J, eds. Physiology of the Gastrointestinal Tract . New York, NY: Raven Press; 1987:685-686. 11. Kubota M, Ito Y, Ikeda K. Membrane properties and innervation of smooth muscle cells in Hirschsprung's disease . Am J Physiol . 1983;244:G406-G415. 12. Reynolds JC, Ouyang A, Lee CA, Baker L, Sunshine AG, Cohen S. Chronic severe constipation: prospective motility studies in 25 consecutive patients . Gastroenterology . 1987;92:414-420. 13. Leon SH, Krishnamurthy S, Schuffler MD. Subtotal colectomy for severe idiopathic constipation: a follow-up study of 13 patients . Dig Dis Sci. 1987;32:1249-1254.Crossref 14. Krishnamurthy S, Schuffler MD, Rohmann CA, Pope CE. Severe idiopathic constipation is associated with a distinctive abnormality of the colonic myenteric plexus . Gastroenterology . 1985;8:26-34.Crossref 15. Meunier P, Louis D, DeBeaujeu MJ. Physiologic investigation of primary chronic constipation in children: comparision with the barium enema study . Gastroenterology . 1984;87:1351-1357. 16. Loening-Beucke V. Abnormal rectoanal function in children recovered from chronic constipation and encopresis . Gastroenterology . 1986;87:1233-1241. 17. Abrahamian PP, Lloyd Still JD. Chronic constipation in childhood: a longitudinal study of 186 patients . J Pediatr Gastroenterol Nutr. 1984;3:460-467.Crossref 18. Swenson O. Sherman JO, Fisher JH. Diagnosis of congenital megacolon: an analysis of 501 patients . J Pediatr Surg. 1973;8:587-591.Crossref 19. Tunnessen WW. Signs and Symptoms in Pediatrics . 2nd ed. Philadelphia, Pa: JB Lippincott; 1988.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Mar 1, 1991

References