Background: Colonic transit is delayed in two-thirds of patients with dyssynergic defecation. As a result, it's possible that dyssynergic defecation and slow transit constipation are linked. There is a scarcity of research on the coexistence of dyssynergic defecation and slow transit constipation, as well as the efficacy of biofeedback therapy in this group of patients. Methods: The results of anorectal manometry and MR defecography were used to make the diagnosis of dyssynergic defecation. The colon transit time was measured with the help of 24 specially marked markers. All of the patients were given biofeedback therapy. Results: The average age of the 17 patients with dyssynergic defecation in the study was 45.6 years. The colon transit time was prolonged in seven patients (41.2%). In anorectal manometry, 7 patients (41.2%) had improved dyssynergic defecation after dyssynergic defecation. When the relationship between colon transit time and biofeedback therapy was investigated, it was discovered that normal colon transit time was found in 85.7 percent of those who benefited from biofeedback therapy, while slow transit constipation was found in 60% of those who did not. Conclusion: In patients with pre- biofeedback therapy and dyssynergic defecation, colon transit time should be evaluated, and it should be kept in mind that these patients may be resistant to treatment in the case of accompanying slow transit constipation.
Aim: Although nonspecific esophageal motility disorder(NEMD) is the most common diagnosis in manometry, unlike other primary esophageal disorders, it is the least known and least studied disorder in the literature. Studies with a small number of patient groups have been reported in the literature. The aim of this study is to share the demographic and clinical characteristics of the single center high-volume NEMD patients we have followed up. Material and Method: The study was carried out retrospectively by examining the motility records of 391 patients diagnosed with NEMD in the motility laboratory of the gastroenterology clinic of our hospital. 20-year motility laboratory records between 1991 and 2019 were reviewed. Results: The mean age of 391 patients diagnosed with NEMD was 49.08±14.4 (18-90). 213 (54.5%) of them were female, and 178 (45.5%) of them were male. The primary symptom was reflux in 56.8% (222/391) of the patients, and dysphagia in 43.2% (169/391). While there was no esophagitis in 78.2% of the patients who had endoscopy, esophagitis was found in 21.8% of them. Pathological reflux was detected in 73.5% of the patients whose 24-hour pH was measured. In the repeated manometry results of patients due to increased complaints in their follow-up whose initial manometry findings were compatible with NEMD, 18 patients were diagnosed with achalasia, 5 patients with nutcracker esophagus, and 4 patients with diffuse esophageal spasm (DES). Conclusion: The majority of patients with NEMD are associated with reflux. Patients with NEMD who do not have endoscopic and radiological organic disorders should be re-evaluated with manometry and further examinations if their complaints persist.
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