title: Gender differences in reduced substance P (SP) in children with slow-transit constipation.
abstract: OBJECTIVE
  Adult slow-transit constipation (STC) occurs predominantly in females and is associated with low numbers of substance P (SP)-containing nerves in colonic circular muscle.
  
  
  OBJECTIVE
  To determine if reduced SP nerves is female predominant in paediatric STC.
  
  
  METHODS
  Children with STC were identified from records of more than 600 nuclear transit studies (NTS) and intestinal biopsies done for intractable chronic constipation between November 1998 and March 2009. Colonic seromuscular biopsies collected from hepatic and splenic flexures, and sigmoid colon were processed for immunohistochemistry. Nerve fibre density in circular muscle containing SP was measured qualitatively by a pathologist.
  
  
  RESULTS
  Eighty-eight children with chronic constipation had both NTS and intestinal biopsies. Seventy-eight children (52 M; age 2-15.5 years; mean 7.7 years) had STC diagnosed by NTS. SP was reduced in 10/26 girls, but only 11/52 boys.
  
  
  CONCLUSIONS
  In this sample, STC was more common in boys than girls. However, in girls with STC, SP deficiency occurred in 40%, when compared with 20% of boys. During puberty, the percentage of girls with reduced SP decreased, whilst the percentage of boys increased. These results suggest that STC is heterogeneous and that there are some gender differences, the implication of which requires further investigation.
authors.affiliation: F Douglas Stephens Surgical Research Laboratory, Murdoch Childrens Research Institute, Melbourne, Australia. yiyik@um.edu.my
authors.forename: Yee Ian
authors.initials: YI
authors.lastname: Yik
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Farmer
authors.forename: Sebastian K
authors.initials: SK
authors.lastname: King
authors.forename: C W
authors.initials: CW
authors.lastname: Chow
authors.forename: John M
authors.initials: JM
authors.lastname: Hutson
authors.forename: Bridget R
authors.initials: BR
authors.lastname: Southwell
mesh_terms: D021581:Active Transport, Cell Nucleus / Q000502:physiology; D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D044684:Colon, Transverse / Q000000981:diagnostic imaging / Q000294:innervation / Q000378:metabolism; D003248:Constipation / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005772:Gastrointestinal Transit; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D008297:Male; D015995:Prevalence; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors; D013373:Substance P / Q000097:blood / Q000172:deficiency*; D014739:Victoria / Q000453:epidemiology
chemical_list: D013373:Substance P