INCREASED PLASMA-LEVELS OF PANCREATIC-POLYPEPTIDE AND DECREASED PLASMA-LEVELS OF MOTILIN IN ENCOPRETIC CHILDREN

Objective. Abnormalities of hormones affecting gastrointestinal motili ty have been found in ''functional'' disorders of the gastrointestinal system in adults. One such disorder of childhood, encopresis, is freq uently associated with constipation, the treatment of which often elim inates the soiling. We hypothesized that hormones affecting gastrointe stinal motility were different between encopretic patients and matched controls. Methods. Ten encopretic patients were matched by age, race, and sex with controls who had no history of encopresis or constipatio n. After an overnight fast, each child consumed a meal of Ensure, the amount of which was based on body weight. Plasma levels of gastrin, pa ncreatic polypeptide, cholecystokinin, motilin, thyroxine, estrogen, a nd insulin were measured 20 and 5 minutes before the meal, and 5, 10, 15, 30, 45, 60, 90, 120, 150, and 180 minutes after the meal. Results. Postprandial levels of pancreatic polypeptide remained consistently h igher and peaked earlier (P < .05) for encopretic patients. The motili n response was lower (P <.03) for encopretic children than for control s. Conclusions. We conclude that pancreatic polypeptide and motilin re sponses to a meal are different in encopretic children than in childre n in the control group. These gastrointestinal hormone findings may in part explain and/or be the result of the severe constipation that fre quently underlies the fecal soiling found in these patients. These fin dings also suggest the motility of the stomach and small intestine may be abnormal in encopresis.