Abstract:
:Idiopathic chronic constipation is a frequent and disabling symptom, but its pathophysiological grounds are still poorly understood. In particular, there is little knowledge about the relationships between distal (anorectal area) and proximal (colonic area) motor abnormalities in this condition, especially concerning high-amplitude propagated colonic activity. For this purpose, we studied 25 patients complaining of severe idiopathic constipation and categorized them as normal- or slow-transit constipation according to colonic transit time. Twenty-five age-matched controls were also studied. Investigations included standard anorectal motility testing and prolonged (24-hr) colonic motility studies. Analysis of results showed that both groups of constipated patients displayed significantly different (P < 0.05) minimum relaxation volumes of the internal anal sphincter, defecatory sensation thresholds, and maximum rectal tolerable volumes with respect to controls. Patients with normal-transit constipation also showed lower internal anal sphincter pressure with respect to slow-transit constipation and controls (P < 0.001 and P < 0.02, respectively). The daily number of high-amplitude propagated contractions (mass movements) as well as their amplitude and duration, was significantly reduced in both subgroups of constipated patients (P < 0.02 vs controls). We conclude that (1) in normal-transit constipation, motor abnormalities are not limited to the anorectal area; (2) patients with slow-transit constipation probably have a severe neuropathic rectal defect; (3) prolonged colonic motility studies may highlight further the functional abnormalities in constipated subjects; and (4) an approach taking into account proximal and distal colon motor abnormalities might be useful to understand pathophysiological grounds of chronic constipation and lead to better therapeutic approaches.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Bassotti G,Chiarioni G,Vantini I,Betti C,Fusaro C,Pelli MA,Morelli Adoi
10.1007/BF02088064subject
Has Abstractpub_date
1994-07-01 00:00:00pages
1558-64issue
7eissn
0163-2116issn
1573-2568journal_volume
39pub_type
杂志文章abstract::In a Caucasian woman with a history of ocular and pulmonary sarcoidosis, the occurrence of sclerosing peritonitis with exudative ascites but without any of the well-known causes of this syndrome prompts us to consider that sclerosing peritonitis is a manifestation of sarcoidosis. The dramatic improvement that occurred...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
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journal_title:Digestive diseases and sciences
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journal_title:Digestive diseases and sciences
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Digestive diseases and sciences
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01296258
更新日期:1984-03-01 00:00:00
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更新日期:1992-05-01 00:00:00
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