Abstract
Annotation. Chronic colostases are characterized by the absence of independent bowel movements due to disturbance of intestinal contractility and evacuatory function of the large intestine which have a negative influence on the development of an organism. The purpose of the study is to evaluate a possibility of predictive diagnostics of motility disorders of the large intestine in children with chronic constipation due to organic causes. The study is based on the determination of serum cholinesterase level in 67 patients of both sexes (main group) which included 25 children suffering from pathology of aganglionic genesis and 42 patients with non-aganglionic congenital anomalies of the large intestine. The average age of the patients was 11.5±0.8 years. The control group included children without any pathologies of gastrointestinal tract and central nervous system. The quantitative determination of cholinesterase level was performed by the photometric method described by Molander and Friedman. The group of children suffering from large intestine anomalies of non-aganglionic origin showed an increase in serum cholinesterase level by 1.08 times. The group of children with anomalies of aganglionic origin showed an increase in cholinesterase level by 1.15 times. The increase in cholinesterase level in patients suffering from colostases of non-aganglionic origin can be regarded as a prognostic indicator having the signs of a factor of organic origin. The increase in cholinesterase level in patients suffering from disorders of aganglionic origin shows the presence of neurobiological changes which cannot be solved simply by surgical correction of a congenital anomaly of the intestine.
Highlights
Chronic colostases are diagnosed in 10-25 % of children and in 70 % of gastroenterological patients and are characterized by the absence of independent bowel movements due to disturbance of intestinal contractility and evacuatory function of the large intestine [4]
Taking into account the diagnostic capacity of the indicator, in order to perform a prognostic evaluation of the large intestine motility we have determined the level of cholinesterase as a subtype of an enzyme which hydrolyzes serum acetylcholine
The results of the study in the group of children suffering from congenital anomalies of the large intestine development of non-aganglionic origin showed a reliable increase in serum cholinesterase level by 1.08 times
Summary
Chronic colostases are diagnosed in 10-25 % of children and in 70 % of gastroenterological patients and are characterized by the absence of independent bowel movements due to disturbance of intestinal contractility and evacuatory function of the large intestine [4]. Modern studies have shown that in the region of neuromuscular junction there are large concentrations of cholinesterase which is able to decompose acetylcholine released from a nerve ending This fact is very important because normally a muscle receives quick successive nervous impulses and the postsynaptic membrane depolarized by the previous dose of acetylcholine has low sensitivity for the dose. To ensure that the successive nerve impulses are able to secure a normal excitatory response, it is necessary to remove the previous dose of mediator before each new impulse arrives This function is performed by cholinesterase due to the fact that choline released from decomposition of acetylcholine is transported back to the nerve ending by a special transport system existing in the presynaptic membrane. The normalization of К+, Nа+ levels leads to the restoration of the membrane polarization and the activation of peristaltic activity of the intestine which is restored if thiamine is used which leads to a decrease of cholinesterase level [1]
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