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Role of proctography in severe constipation.
A Infantino1, A Masin, P Pianon
1Department of Surgery I, University of Padova, Italy.
Diseases of the Colon and Rectum
|August 1, 1990
Summary
Constipation may stem from pelvic floor dysfunction. Proctography revealed pelvic floor alterations in some patients, though not directly correlating with constipation severity or transit time, but with age.
Area of Science:
- Gastroenterology
- Pelvic Floor Disorders
- Digestive Health
Background:
- Constipation is often linked to pelvic floor issues, including spasticity or weakness.
- Dietary interventions like high-fiber diets are common first-line treatments.
Purpose of the Study:
- To investigate pelvic floor function in severely constipated patients unresponsive to dietary changes.
- To correlate findings from whole gut transit time, proctography, and anorectal manometry with constipation severity.
Main Methods:
- Whole gut transit time (TT), proctography, and anorectal manometry were performed on 22 constipated patients and control groups.
- Patients were analyzed based on proctographic findings into Group A (normal) and Group B (paradoxical closure).
Main Results:
- All constipated patients exhibited delayed transit time (P < 0.001).
- Manometry showed a higher rectal sensory threshold in constipated patients (P < 0.01).
- Proctography identified paradoxical anorectal angle closure during straining in 12 patients (Group B), with a higher distance from the pubococcygeal line compared to controls and Group A.
Conclusions:
- Proctography can reveal pelvic floor alterations in chronic constipation.
- No direct correlation was found between proctographic findings and rectal/colonic stasis or constipation severity.
- Patient age correlated with specific proctographic findings (Group B).