Related Experiment Video
Updated: Jul 6, 2025
03:50
Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease
Published on: August 18, 2023
1.8K
Obesity Is Associated with Altered Rectal Sensitivity in Chronic Constipation
Nayna A Lodhia1,2, Brent Hiramoto1,2, Laura Horton2,3
1Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Digestive Diseases and Sciences
|January 6, 2024
Summary
Obesity is linked to changes in rectal sensation for individuals with chronic constipation (CC). This suggests altered rectal sensitivity plays a key role in CC among obese patients, impacting anorectal function.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Obesity Medicine
Background:
- Defecation dysfunction is a potential contributor to chronic constipation (CC).
- The specific influence of obesity on anorectal physiology in CC patients is not well understood.
- This study investigates the relationship between obesity and anorectal function in CC.
Purpose of the Study:
- To evaluate the impact of obesity on anorectal function in patients with chronic constipation.
- To determine if obesity is associated with specific defecation dysfunctions identified through physiologic testing.
- To explore the role of altered rectal sensitivity in CC among obese individuals.
Main Methods:
- Retrospective cohort study of 383 adult patients with CC undergoing high-resolution anorectal manometry (HRAM).
- Patients were categorized into obese (BMI > 30 kg/m²) and non-obese (BMI < 30 kg/m²) groups.
- Univariate and multivariable regression analyses were performed to assess associations between obesity and HRAM findings.
Main Results:
- Obese patients exhibited lower anal sphincter resting tone and maximum squeeze pressure compared to non-obese patients.
- No significant differences were observed in dyssynergia or failed balloon expulsion between the groups.
- Obesity was associated with significantly increased maximum tolerated and urge sensation volumes during balloon distention testing.
- Obesity remained independently associated with increased maximum tolerated rectal volume after adjustment for confounders.
Conclusions:
- Obesity is independently associated with altered rectal sensitivity in patients with chronic constipation.
- Altered rectal sensation may be a significant factor in the pathophysiology of CC in obese individuals.
- Anorectal physiology testing is crucial for understanding CC and guiding management, particularly in the context of obesity.
Related Concept Videos
01:25Assessment of the Rectum and Anus
224
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
224
01:21Drugs for Treatment of Constipation-Predominant IBS
172
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
172
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
164
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
164
01:17Irritable Bowel Syndrome I: Introduction
277
Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
277
01:17Drugs for Treatment of Diarrhea-Predominant IBS
177
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
177
01:17Chronic Bowel Disorders: Introduction
455
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
455