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--- In Meta-mito-autism@yahoogroups.com, Plant <aplant@g...> wrote:

PEDIATRICS Vol. 112 No. 4 October 2003, pp. 939-942



Constipation With Acquired Megarectum in Children With Autism



Nadeem Afzal,Simon Murch, PhD, Kumran Thirrupathy, , Leslie Berger,

Andrew Fagbemi, and Robert Heuschkel,



Department of Radiology, Royal Free Hospital, Hampstead, London,

United

Kingdom



Objective. Recent evidence suggests that autistic children may have

significant gastrointestinal symptoms. Although constipation occurs

in

2% to 5% of healthy children, its clinical diagnosis is often

difficult

in children with behavioral disorders. We thus aimed to assess the

prevalence of fecal loading in autistic children with

gastrointestinal

symptoms and to identify possible predictors of constipation.



Methods. We studied abdominal radiographs of 103 autistic children

(87

boys) who were referred for gastroenterological assessment, in

comparison with 29 control radiographs from children who were

referred

to the emergency department, most with abdominal pain. Radiographs

were

scored independently, in blinded manner, by 4 pediatric

gastroenterologists and a radiologist. The severity of constipation

was

determined using a validated index. Details of stool habit,

abdominal

pain, dietary history, and laxative use were obtained from case

notes.



Results. The incidence of constipation in the control subjects with

abdominal pain was higher than reported for normal children. Despite

this, moderate or severe constipation was more frequent in the

autistic

group than in the control subjects (36% vs 10%). Analysis of

rectosigmoid loading showed more striking differences (54.4% of

autistic

children had moderate/severe loading or acquired megarectum compared

with 24.1% of control subjects). Multivariate regression analysis

showed

consumption of milk to be the strongest predictor of constipation in

the

autistic group, whereas stool frequency, gluten consumption,

soiling,

and abdominal pain were not predictive of constipation.



Conclusions. Constipation is a frequent finding in children with

gastrointestinal symptoms and autism, particularly in the

rectosigmoid

colon, often with acquired megarectum. The absence of any

correlation

between the clinical history and the degree of fecal impaction in

autistic children confirms the importance of an abdominal radiograph

in

the assessment of their degree of constipation.

--- End forwarded message ---



heyou

刘建树

能否翻译中文，便于英文水平不好的家长阅读。