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Streamlining the management of defecation disorders.
I R Berman1, D H Manning, M S Harris
1Colon and Rectal Clinic, Brunswick, Georgia.
Diseases of the Colon and Rectum
|September 1, 1990
Summary
Diagnosing and treating severe constipation is now more specific. Simple tools like cinedefecography and colonic transit studies help identify causes and guide effective therapies for over 700 patients.
Area of Science:
- Gastroenterology
- Physiology
Background:
- Obstinate constipation is a common and challenging gastrointestinal symptom.
- Advances in understanding defecation physiology and diagnostic tools enhance treatment specificity.
Purpose of the Study:
- To evaluate the diagnostic utility and therapeutic success of readily available techniques in severely constipated patients.
- To correlate objective findings with treatment outcomes in a large patient series.
Main Methods:
- Utilized cinedefecography, pelvic floor electromyography, and rectoanal inhibitory reflex testing.
- Assessed colonic transit time using a marker capsule and abdominal X-rays in select patients.
- Included over 700 severely constipated patients.
Main Results:
- Over 70% overall therapeutic success was achieved.
- Colonic hypomotility (inertia) and functional outlet obstruction were identified as key diagnoses.
- Objective, anatomically specific evidence guided treatment decisions.
Conclusions:
- Orderly application of simple, available diagnostic techniques can effectively diagnose and guide treatment for disordered defecation.
- This approach offers rapid, objective evidence for managing severe constipation.
- Increased specificity in diagnosis leads to improved therapeutic success.