Chronic intestinal pseudoobstruction associated with fetal alcohol syndrome

Alcohol acts as a teratogen in the fetus,resulting in prenatal or postnatal growth failure,characteristic facial dysmorphic features, and centralnervous system dysfunction. The toxic effects of alcohol on the developing brain are well recognized,but gastrointestinal neuropathy has not been describedin fetal alcohol syndrome (FAS). Five children with FASpresented in infancy with signs and symptoms suggestive of chronic intestinal pseudoobstruction. Theywere not able to sustain adequate caloric intake bymouth, and all required prolonged special methods ofalimentation. We performed antroduodenal manometry in these children to determine whether theirsymptoms were associated with a gastrointestinalmotility disorder. All patients had abnormallypropagating phase III-like episodes during fasting(retrograde in four, simultaneous in two). Persistentclusters of stationary contractions were a prominentfeature in two patients. In utero neurotoxicity ofalcohol may not be limited to the central nervoussystem, but may also cause an enteric neuropathypresenting in infancy as chronic intestinalpseudoobstruction.