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Symptoms and physiology in severe chronic constipation
H Mertz1, B Naliboff, E A Mayer
1Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
The American Journal of Gastroenterology
|February 6, 1999
Summary
Constipation symptoms can be categorized into three subgroups: slow colonic transit, irritable bowel syndrome (IBS), and pelvic floor dysfunction (PFD). While slow transit and IBS symptoms align with physiological findings, PFD symptoms do not correlate with physical measures.
Area of Science:
- Gastroenterology
- Physiology
Background:
- Constipation is often attributed to slow colon transit, irritable bowel syndrome (IBS), or pelvic floor dysfunction (PFD).
- Understanding symptom-based subgroups is crucial for accurate diagnosis and treatment.
Purpose of the Study:
- To identify distinct symptom-based subgroups of constipation.
- To investigate if these subgroups correlate with specific colonic transit and anorectal sensorimotor functions.
Main Methods:
- 108 constipated patients completed questionnaires.
- Colon transit studies, anorectal manometry, and rectal sensory testing were performed.
- Factor analysis of symptoms was used to correlate with physiological findings.
Main Results:
- Three symptom factors emerged: slow colonic transit, IBS, and PFD.
- Slow transit symptoms correlated with colon transit times.
- IBS symptoms correlated with rectal hypersensitivity; PFD symptoms did not correlate with defecatory function measures.
Conclusions:
- Constipation can be classified into three symptom-based subgroups: slow transit, IBS, and PFD.
- Slow transit and IBS subgroups showed expected physiological correlations.
- PFD symptoms and physiology did not demonstrate a correlation in this study.