Prolonged (24-Hour) Manometric Recording of Rectal Contractile Activity in Patients with Slow Transit Constipation

Abstract

A periodic motor activity, named the rectal motor complex, has been recently described in the healthy human rectum. We studied the rectal contractile activity for 24 h by a low compliance manometric system in a group of 10 women with slow transit constipation. Analysis of the 24-hour manometric recordings showed that these subjects: (1) had overall scarce rectal motility; (2) display few rectal motor complexes (average, 3.3 ± 1.3/subject/24 h) which are irregularly distributed over time, and (3) respond weakly to ingestion of a standard meal (average duration of the motor response 19 ± 6 min). The observations suggest that an underlying neuropathic process may be involved in the pathogenesis of the impaired rectal motility in patients with slow transit constipation.

Altered periodic rectal motor activity: a mechanism for slow transit constipation

“…In healthy volunteers, we have shown that the PRMA is confined largely to the rectosigmoid region, often follows a motor event in the more proximal colon, and that there is a distinct circadian rhythm 4 . However, whether this motor activity is altered in patients with functional chronic constipation is controversial 6 , 7 . In one retrospective study, it was claimed that patients with slow transit constipation exhibited fewer PRMA cycles, 7 but there were no control data.…”

“…However, whether this motor activity is altered in patients with functional chronic constipation is controversial 6 , 7 . In one retrospective study, it was claimed that patients with slow transit constipation exhibited fewer PRMA cycles, 7 but there were no control data. In contrast, another study using solid‐state manometry suggested that patients with slow transit constipation exhibited a tendency for increased incidence of PRMA 6 .…”

Contractile activity of the human colon: lessons from 24 hour studies.

“…A recent study showed that chronically constipated subjects displayed significantly fewer high amplitude propagated contractions and a decreased frequency of urge to defecate,56 suggesting that one important pathophysiological mechanism for constipation may be a decrease in the propulsive ability of the viscus. Other studies have disclosed that patients complaining of slow transit constipation have impaired cyclic rectal activity,57 58 suggesting that these patients have a motor neuropathy.…”

Detubularized rectosigmoid neobladder in women after cystectomy for bladder cancer

“…Detubularization reduces the volume-dependent high endoluminal pressure and most of the neobladder contractile activity. The incision for detubularization must be extended as far as the rectosigmoid junction to deactivate the intestinal pacemaker, which has been implicated in colonic pathologies such as constipation and irritable bowel syndrome [4].…”