期刊
BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY
卷 25, 期 1, 页码 43-57出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.bpg.2010.12.001
关键词
Chronic constipation; Enteric nervous system; Histopathology; Enteric neuropathy; Enteric myopathy; Interstial cells of Cajal; Slow-transit constipation
资金
- HEFCE
- NIH [DK57061, DK52766, DK68055]
Some patients with chronic constipation may undergo colectomy yielding tissue appropriate to diagnosis of underlying neuromuscular pathology. The analysis of such tissue has, over the past 40 years, fuelled research that has explored the presence of neuropathy, myopathy and more recently changes in interstitial cells of Cajal (ICC). In this chapter, the data from these studies have been critically reviewed in the context of the significant methodological and interpretative issues that beset the field of gastrointestinal neuromuscular pathology. On this basis, reductions in ICC appear to a consistent finding but one whose role as a primary cause of slow-transit constipation requires further evaluation. Findings indicative of significant neuropathy or myopathy are variable and in many studies subject to considerable methodological bias. Methods with practical diagnostic utility in the individual patient have rarely been employed and require further validation in respect of normative data. (C) 2010 Elsevier Ltd. All rights reserved.
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