Treatment-Resistant Constipation in Children
Dr. Southwell is the recipient of the IFFGD 2005 Research Award to Pediatric Investigator, Basic Science. She has brought her skills in basic neurogastroenterology to understanding the causes of functional disturbances of colonic motility in children. She has also been coordinating a critical evaluation of a method to overcome constipation and soiling. Dr. Southwell aims to use multidisciplinary approaches to understand events that occur in normal and disease states, to provide a basis for effective treatment.
Summary
Constipation and fecal soiling in children and teenagers are major impediments to education. Schools will not accept children who cannot toilet themselves. Children whose soiled clothing gives off an odor are ostracized by others. Ten percent of 10 year old children have soiling. Paradoxically, 90% of children with soiling have constipation with bypass soiling (functional fecal retention and encopresis). Most of these children will respond to changes in diet and laxatives, but in 1 out of 200 constipation is not responsive to treatment and continues into adulthood.
Six Point Plan for Treatment-Resistant Constipation
We have developed a 6 point approach to treating children with chronic constipation. We have been excited to find that the method we developed overcomes constipation and stops soiling. We have tested the method on 8 children. Five of the eight started passing stool normally and all stopped soiling. The effects last between 1 month and 3 months. We need to test the method on a larger group of children.
Studies on the Nervous System Controlling the Gut
As well as working directly on children, I do laboratory studies to understand the chemical structure of the nerves in the intestine. These studies help us to understand the function of different nerves and to develop methods and expertise to support the studies on human intestinal dysmotility.
- Due to defects at the anus causing outlet obstruction,
- Due to weak propulsion in the proximal colon,
- Due to psychological or behavioral factors,
- Associated with other organic or metabolic defects.