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Which physiologic tests are useful in patients with constipation?
1Division of Colon and Rectal Surgery, The George Washington University, Washington, DC 20037, USA.
Diseases of the Colon and Rectum
|June 30, 1998
Summary
Physiologic testing aided diagnosis in half of severe constipation patients. History and symptoms did not predict which patients benefited most from these diagnostic studies.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Pelvic Floor Disorders
Background:
- Severe constipation management often involves complex physiologic testing.
- Understanding the diagnostic utility of these tests is crucial for patient care.
Purpose of the Study:
- To evaluate the role of physiologic testing in diagnosing and directing treatment for severe constipation.
- To assess the diagnostic accuracy and impact of various tests.
Main Methods:
- Prospective review of 104 patients with severe idiopathic constipation who underwent physiologic testing.
- Analysis of pretesting impressions, test results, and historical features.
- Evaluation of diagnostic accuracy and impact on treatment plans.
Main Results:
- Physiologic testing provided significant diagnostic information in 47% of patients with uncertain initial impressions.
- Defecography and colonic transit times were identified as the most useful tests.
- Prior hysterectomy, urinary incontinence, and pelvic outlet obstruction symptoms correlated with rectocele incidence.
Conclusions:
- Physiologic testing is valuable, aiding specific diagnoses in approximately half of severe constipation cases.
- Pretesting clinical information was insufficient to predict which patients would benefit most from these studies.