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Rectal Hyposensitivity Is Associated With a Defecatory Disorder But Not Delayed Colon Transit Time in a Functional Constipation Population.
Medicine (Baltimore) 2016; 95(19):e3667M

Abstract

The physiological mechanism of functional constipation (FC) includes defecatory disorders and delayed colon transit. About 18% to 68% constipated patients may have rectal hyposensitivity (RH). We performed this study to investigate the association between RH and functional defecatory disorder (FDD) as well as that between RH and delayed colon transit in FC patients.A total of 218 FC patients were enrolled. The constipation severity instrument (CSI) was used to assess constipation symptoms. High-resolution anorectal manometry (HR-ARM), defecography, balloon expulsion tests, and colon transit studies were performed for each patient. RH was defined as 1 or more sensory threshold pressures raised beyond the normal range based on HR-ARM. We investigated the association between RH and constipation symptoms, and the occurrence of FDD and delayed CTT. Ninety FDD patients completed the initial phase of biofeedback treatment (BFT). We investigated the association between RH and the effect of BFT.Totally 122 (56.0%) patients had RH. The total CSI (49.82 ± 1.09 vs 41.25 ± 1.55, P = 0.023) and obstructive defecation subscale scores (23.19 ± 0.69 vs 17.07 ± 0.90, P < 0.001) were significantly higher in RH than in non-RH patients. No significant difference was observed in slow transit symptoms (21.77 ± 0.72 vs 19.90 ± 0.85, P = 0.121) or abdominal pain (6.85 ± 2.61 vs 5.00 ± 1.04, P = 0.380). The frequency of prolonged CTT was not significantly different between RH and non-RH groups (54.1% vs 58.3%, P = 0.403). RH patients rated more occurrence of FDD (72.1% vs 53.1%, P = 0.014) and dysynergic defecation (79.8% vs 50.2%, P = 0.004) than non-RH patients, whereas no differences were seen for inadequate defecatory propulsion (59.2% vs 55.0%, P = 0.589). After BFT, the proportion of "no effect" was significantly higher in the RH group than in the non-RH group (22.4% vs 9.4%, P = 0.010).RH is associated with obstructive defecation symptoms and the occurrence of FDD. Further studies are needed to detect the mechanism of RH's effect on BFT and FC.

Authors+Show Affiliations

From the Department of Gastroenterology (TY, YZ, YJ, PW, LL); Pancreas Center (DQ), the First Affiliated Hospital of Nanjing Medical University; Pancreas Institute (DQ), Nanjing Medical University; and Qinglongshan Mental Hospital (PW), Nanjing, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27175697

Citation

Yu, Ting, et al. "Rectal Hyposensitivity Is Associated With a Defecatory Disorder but Not Delayed Colon Transit Time in a Functional Constipation Population." Medicine, vol. 95, no. 19, 2016, pp. e3667.
Yu T, Qian D, Zheng Y, et al. Rectal Hyposensitivity Is Associated With a Defecatory Disorder But Not Delayed Colon Transit Time in a Functional Constipation Population. Medicine (Baltimore). 2016;95(19):e3667.
Yu, T., Qian, D., Zheng, Y., Jiang, Y., Wu, P., & Lin, L. (2016). Rectal Hyposensitivity Is Associated With a Defecatory Disorder But Not Delayed Colon Transit Time in a Functional Constipation Population. Medicine, 95(19), pp. e3667. doi:10.1097/MD.0000000000003667.
Yu T, et al. Rectal Hyposensitivity Is Associated With a Defecatory Disorder but Not Delayed Colon Transit Time in a Functional Constipation Population. Medicine (Baltimore). 2016;95(19):e3667. PubMed PMID: 27175697.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rectal Hyposensitivity Is Associated With a Defecatory Disorder But Not Delayed Colon Transit Time in a Functional Constipation Population. AU - Yu,Ting, AU - Qian,Dong, AU - Zheng,Yongping, AU - Jiang,Ya, AU - Wu,Ping, AU - Lin,Lin, PY - 2016/5/14/entrez PY - 2016/5/14/pubmed PY - 2017/2/7/medline SP - e3667 EP - e3667 JF - Medicine JO - Medicine (Baltimore) VL - 95 IS - 19 N2 - The physiological mechanism of functional constipation (FC) includes defecatory disorders and delayed colon transit. About 18% to 68% constipated patients may have rectal hyposensitivity (RH). We performed this study to investigate the association between RH and functional defecatory disorder (FDD) as well as that between RH and delayed colon transit in FC patients.A total of 218 FC patients were enrolled. The constipation severity instrument (CSI) was used to assess constipation symptoms. High-resolution anorectal manometry (HR-ARM), defecography, balloon expulsion tests, and colon transit studies were performed for each patient. RH was defined as 1 or more sensory threshold pressures raised beyond the normal range based on HR-ARM. We investigated the association between RH and constipation symptoms, and the occurrence of FDD and delayed CTT. Ninety FDD patients completed the initial phase of biofeedback treatment (BFT). We investigated the association between RH and the effect of BFT.Totally 122 (56.0%) patients had RH. The total CSI (49.82 ± 1.09 vs 41.25 ± 1.55, P = 0.023) and obstructive defecation subscale scores (23.19 ± 0.69 vs 17.07 ± 0.90, P < 0.001) were significantly higher in RH than in non-RH patients. No significant difference was observed in slow transit symptoms (21.77 ± 0.72 vs 19.90 ± 0.85, P = 0.121) or abdominal pain (6.85 ± 2.61 vs 5.00 ± 1.04, P = 0.380). The frequency of prolonged CTT was not significantly different between RH and non-RH groups (54.1% vs 58.3%, P = 0.403). RH patients rated more occurrence of FDD (72.1% vs 53.1%, P = 0.014) and dysynergic defecation (79.8% vs 50.2%, P = 0.004) than non-RH patients, whereas no differences were seen for inadequate defecatory propulsion (59.2% vs 55.0%, P = 0.589). After BFT, the proportion of "no effect" was significantly higher in the RH group than in the non-RH group (22.4% vs 9.4%, P = 0.010).RH is associated with obstructive defecation symptoms and the occurrence of FDD. Further studies are needed to detect the mechanism of RH's effect on BFT and FC. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/27175697/Rectal_Hyposensitivity_Is_Associated_With_a_Defecatory_Disorder_But_Not_Delayed_Colon_Transit_Time_in_a_Functional_Constipation_Population_ L2 - http://Insights.ovid.com/pubmed?pmid=27175697 DB - PRIME DP - Unbound Medicine ER -