Role of enteric nervous system in child health

The enteric nervous system (ENS), often termed the “second brain,” plays a crucial role in gastrointestinal function and has significant implications for child health. Emerging evidence highlights its involvement in neurodevelopmental, infectious, and congenital disorders. In autism spectrum disorder, ENS dysfunction is associated with altered gut motility, visceral hypersensitivity, and microbiota–gut–brain axis disturbances, contributing to common gastrointestinal symptoms and potentially influencing behavioral manifestations. Varicella zoster virus, though primarily neurotropic for sensory ganglia, can affect the ENS, leading to enteric neuropathy and gastrointestinal dysmotility, particularly in immunocompromised children. Hirschsprung disease represents a classical ENS disorder, characterized by congenital absence of enteric ganglion cells in the distal bowel, resulting in functional intestinal obstruction and enterocolitis. Understanding ENS development, function, and pathology provides valuable insights into the pathophysiology of diverse pediatric conditions and underscores the importance of integrated neurogastroenterological approaches in child health and disease management.