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Changes in colorectal function in severe idiopathic chronic constipation.

P Shouler, M R Keighley

    Gastroenterology
    |February 1, 1986
    PubMed
    Summary
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    Severe chronic constipation in adults is often linked to impaired rectal sensation and delayed colonic transit. Pelvic floor motor abnormalities were observed in patients with idiopathic constipation.

    Area of Science:

    • Gastroenterology
    • Colorectal Physiology
    • Clinical Investigation

    Background:

    • Idiopathic constipation is a prevalent condition affecting quality of life.
    • Understanding the underlying physiological mechanisms is crucial for effective treatment.

    Purpose of the Study:

    • To investigate colorectal and anal function in adult patients with severe idiopathic long-standing constipation.
    • To compare physiological parameters between constipated patients and healthy controls.

    Main Methods:

    • Physiologic studies including anal manometry, rectal sensitivity testing, and colonic transit time measurements.
    • Electromyography of the pelvic floor and sigmoid motility index assessment.
    • Evaluation of anorectal angles during attempted defecation.

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    Main Results:

    • Impaired rectal sensation (p<0.01) and reduced anorectal angles during defecation (p<0.001) were observed in constipated patients.
    • Delayed colonic transit time (p<0.02) and impaired response to bisacodyl (p<0.01) were noted.
    • Increased puborectalis activity was found in some patients, suggesting pelvic floor dysfunction.

    Conclusions:

    • Severe idiopathic constipation is associated with significant physiological abnormalities in rectal sensation, anorectal function, and colonic motility.
    • These findings suggest motor abnormalities of the pelvic floor and colon contribute to chronic constipation.