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Radiologic studies of rectal evacuation in adults with idiopathic constipation
G K Turnbull1, C I Bartram, J E Lennard-Jones
1St. Mark's Hospital, London, United Kingdom.
Diseases of the Colon and Rectum
|March 1, 1988
Summary
Idiopathic constipation is characterized by delayed rectal expulsion and incomplete barium evacuation, indicating defecatory impairment. These findings were observed using evacuation proctography in patients compared to healthy controls.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Diagnostic Imaging
Background:
- Idiopathic constipation is a common condition with varying underlying mechanisms.
- Evacuation proctography is a key diagnostic tool for assessing anorectal function.
Purpose of the Study:
- To evaluate defecatory dynamics in patients with idiopathic constipation using evacuation proctography.
- To identify objective differences in rectal expulsion between constipated patients and healthy controls.
Main Methods:
- Evacuation proctography was performed on 58 patients with idiopathic constipation and 20 controls.
- Measurements included time to expel barium and the amount of barium remaining in the distal rectum.
Main Results:
- Constipated patients showed significantly longer barium expulsion times compared to controls.
- A majority of constipated patients failed to evacuate at least 60% of barium from the distal rectum, unlike controls.
- Anorectal angle, pelvic floor descent, and rectocele presence did not differentiate groups.
Conclusions:
- Evacuation proctography reveals significant defecatory impairment in idiopathic constipation, primarily related to delayed and incomplete rectal expulsion.
- While anatomical factors were not discriminative, functional deficits in rectal emptying are evident.