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Chronic idiopathic constipation: more than a simple colonic transit disorder.
Shabana Shahid1, Zeeshan Ramzan, Alan H Maurer
1Gastroenterology Section, Department of Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USA.
Journal of Clinical Gastroenterology
|October 21, 2011
Summary
Most chronic idiopathic constipation patients have colonic motor disorders like slow transit constipation or dyssynergic defecation. Many also experience upper gastrointestinal tract transit issues concurrently.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Physiology
Background:
- Constipation affects up to 28% of Americans, presenting in four pathophysiologic patterns.
- It can be associated with generalized gastrointestinal (GI) tract transit disorders.
- Understanding these patterns is crucial for effective management.
Purpose of the Study:
- To determine the prevalence of different pathophysiologic subtypes in constipated patients.
- To evaluate the percentage of constipated patients with diffuse GI tract transit disorders.
Main Methods:
- Retrospective analysis of 212 patients with intractable constipation.
- Procedures included anorectal manometry, electromyography, balloon expulsion testing, defecography, and whole-gut transit scintigraphy.
Main Results:
- 42% had slow transit constipation, 12% dyssynergic defecation, 25% both, and 20% neither.
- Among slow transit constipation patients, 34% had delayed gastric emptying and 10% delayed small bowel transit.
- Similar upper GI transit disorders were found across all colonic motility patterns.
Conclusions:
- The majority of chronic idiopathic constipation (CIC) patients (80%) exhibit colonic motor disorders.
- A significant portion of CIC patients (51%) also have concurrent upper GI tract transit disorders.
- This highlights the systemic nature of GI transit issues in CIC.
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