Constipation Assessed on the Basis of Colorectal Physiology

GLIA, G. LINDBERG A.

doi:10.1080/00365529850172359

Cited by 42 publications

(5 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regardless, our study illustrates that some patients can have both dyssynergic defecation and delayed colonic transit. Previous studies have shown that there is an overlap between dyssynergic defecation and slow transit constipation [ 13 , 23 , 24 , 25 ]. Why some patients have both disorders is not clear.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Clinical Characteristics of Dyssynergic Defecation and Slow Transit Constipation in Patients with Chronic Constipation

Tanner

Chaudhry

Goraya

et al. 2021

JCM

View full text Add to dashboard Cite

Patients with chronic constipation who do not respond to initial treatments often need further evaluation for dyssynergic defecation (DD) and slow transit constipation (STC). The aims of this study are to characterize the prevalence of DD and STC in patients referred to a motility center with chronic constipation and correlate diagnoses of DD and STC to patient demographics, medical history, and symptoms. High-resolution ARM (HR-ARM), balloon expulsion testing (BET) and whole gut transit scintigraphy (WGTS) of consecutive patients with chronic constipation were reviewed. Patients completed questionnaires describing their medical history and symptoms at the time of testing. A total of 230 patients completed HR-ARM, BET, and WGTS. Fifty (22%) patients had DD, and 127 (55%) patients had STC. Thirty patients (13%) had both DD and STC. There were no symptoms that were suggestive of STC vs. DD; however, patients with STC and DD reported more severe constipation than patients with normal transit and anorectal function. Patients with chronic constipation often need evaluation for both DD and STC to better understand their pathophysiology of symptoms and help direct treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence and Clinical Characteristics of Dyssynergic Defecation and Slow Transit Constipation in Patients with Chronic Constipation

Tanner

Chaudhry

Goraya

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…As the BET technique was not standardized, the included articles described different methodologies [33, 34, 39–43]. Most studies of this meta-analysis described the use of the seated position (12 studies) probably because this method better resembles the act of defecation.…”

Section: Discussionmentioning

confidence: 99%

“…Although probably air simulates inadequately the stool weight and consistency, we did not see any difference in sensitivity and specificity, perhaps because of the low number of patients evaluated (301 out of 1450). Another aspect to take into account is the volume of the balloon—the majority of the studies reported fixed volumes in their series but the volume described varied between 10 mL [45] and 60 mL [43]; in addition, a study described a variable volume (median volume of 250 mL) related to the permanent desire to evacuate [33]. When we use the cut-off of ≥50 mL, the sensitivity and specificity did not change, nor when we exclude only Minguez series (median volume of 250 mL).…”

Section: Discussionmentioning

confidence: 99%

Digital Rectal Examination and Balloon Expulsion Test in the Study of Defecatory Disorders: Are They Suitable as Screening or Excluding Tests?

Caetano

Cruz

Rolanda

2016

Canadian Journal of Gastroenterology and Hepatology

View full text Add to dashboard Cite

Background. Rome III criteria add physiological criteria to symptom-based criteria of chronic constipation (CC) for the diagnosis of defecatory disorders (DD). However, a gold-standard test is still lacking and physiological examination is expensive and time-consuming. Aim. Evaluate the usefulness of two low-cost tests—digital rectal examination (DRE) and balloon expulsion test (BET)—as screening or excluding tests of DD. Methods. We performed a systematic search in PUBMED and MEDLINE. We selected studies where constipated patients were evaluated by DRE or BET. Heterogeneity was assessed and random effect models were used to calculate the sensitivity, specificity, and negative predictive value (NPV) of the DRE and the BET. Results. Thirteen studies evaluating BET and four studies evaluating DRE (2329 patients) were selected. High heterogeneity (I 2 > 80%) among studies was demonstrated. The studies evaluating the BET showed a sensitivity and specificity of 67% and 80%, respectively. Regarding the DRE, a sensitivity of 80% and specificity of 84% were calculated. NPV of 72% for the BET and NPV of 64% for the DRE were estimated. The sensitivity and specificity were similar when we restrict the analysis to studies using Rome criteria to define CC. The BET seems to perform better when a cut-off time of 2 minutes is used and when it is compared with a combination of physiological tests. Considering the DRE, strict criteria seem to improve the sensitivity but not the specificity of the test. Conclusion. Neither of the low-cost tests seems suitable for screening or excluding DD.

show abstract

“…FC may result from diverse pathophysiologies, such as delayed colonic transit and/or pelvic floor dysfunction [8]. RH may also be important in the etiology of constipation in some patients, as it is the only demonstrable physiological abnormality in half of such patients [9].…”

Section: Discussionmentioning

confidence: 99%

Rectal hyposensitivity and functional anorectal outlet obstruction are common entities in patients with functional constipation but are not significantly associated

Lee

Hong

et al. 2013

Korean J Intern Med

View full text Add to dashboard Cite

Background/AimsThe causes of functional anorectal outlet obstruction (outlet obstruction) include functional defecation disorder (FDD), rectocele, and rectal intussusception (RI). It is unclear whether outlet obstruction is associated with rectal hyposensitivity (RH) in patients with functional constipation (FC). The aim of this study was to determine the association between RH and outlet obstruction in patients with FC.MethodsThis was a retrospective study using a prospectively collected constipation database, and the population comprised 107 patients with FC (100 females; median age, 49 years). We performed anorectal manometry, defecography, rectal barostat, and at least two tests (balloon expulsion test, electromyography, or colon transit time study). RH was defined as one or more sensory threshold pressures raised beyond the normal range on rectal barostat. We investigated the association between the presence of RH and an outlet obstruction such as large rectocele (> 2 cm in size), RI, or FDD.ResultsForty patients (37.4%) had RH. No significant difference was observed in RH between patients with small and large rectoceles (22 [44.9%] vs. 18 [31%], respectively; p = 0.140). No significant difference was observed in RH between the non-RI and RI groups (36 [36.7%] vs. 4 [30.8%], respectively; p = 0.599). Furthermore, no significant difference in RH was observed between the non-FDD and FDD groups (19 [35.8%] vs. 21 [38.9%], respectively; p = 0.745).ConclusionsRH and outlet obstruction are common entities but appear not to be significantly associated.

show abstract

Constipation Assessed on the Basis of Colorectal Physiology

Abstract: About two-thirds of our patients with constipation had objective evidence of delayed transit or pelvic-floor dysfunction. No single test could reliably identify any of the pathophysiologic subgroups of constipation.

Cited by 42 publications

References 45 publications

Prevalence and Clinical Characteristics of Dyssynergic Defecation and Slow Transit Constipation in Patients with Chronic Constipation

Prevalence and Clinical Characteristics of Dyssynergic Defecation and Slow Transit Constipation in Patients with Chronic Constipation

Digital Rectal Examination and Balloon Expulsion Test in the Study of Defecatory Disorders: Are They Suitable as Screening or Excluding Tests?

Rectal hyposensitivity and functional anorectal outlet obstruction are common entities in patients with functional constipation but are not significantly associated

Contact Info

Product

Resources

About