Abstract
We have previously described non-specific proctoscopic findings in children with this syndrome. A further 59 patients ranging in age from 2 to 17 years have been studied. Rectal suction biopsy specimens were examined in buffered formalin, using a dissecting microscope. Serial sections were scrutinized histologically. Mucus was present covering speciments from 17 cases. In 29 patients a single vessel surrounding the cryptal offices was regular and distinct, but consisted of duplicated regular vessel in 19 and irregular disoriented capillaries in 11. Forty biopsies showed aggregations of lymphoid tissue, represented by pale areas over which vessel architecture in lost. Volcanic cone-like openings to the crypts were seen in 51. The muscularis mucosa appeared granular and glistening white in 50 cases, but was greyish yellow in four children with severe symptoms. In 5 children histology was normal but in the others a pattern emerage. Goblet cells are increased in size and number. The glands vary in size, with balooning, angulation and loss of parallel vertical formation. As a result the intercryptal space narrow, and “ghosts” of disintegrated entire glands appear. Compared with inflammatory colitis there is a decrease in cell population. Mucophages may appear in large clusters or invade the muscularis. Dissecting microscopy shows anatomical variation of vessels in 50%. Histology demonstrates an increase in mucus secreting cells and a diminution of cell population in the lamina propria.
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Gibbons, I., Nedwich, A., Appleman, H. et al. Irritable bowel syndrome in childhood: The nature of the rectal mucosa correlating proctoscopy. Pediatr Res 5, 390 (1971). https://doi.org/10.1203/00006450-197108000-00081
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DOI: https://doi.org/10.1203/00006450-197108000-00081