RT Journal
A1 Bassotti G, Chistolini F, Nzepa F, Morelli A
T1 COlonic propulsive impairment in intractable slow-transit constipation
JF Archives of Surgery
JO Archives of Surgery
YR 2003
FD December 1
VO 138
IS 12
SP 1302
OP 1304
DO 10.1001/archsurg.138.12.1302
UL http://dx.doi.org/10.1001/archsurg.138.12.1302
AB Hypothesis 
    Intractable constipation, especially of the slow-transit subtype, may represent several pathophysiologic entities with a common final symptomatic appearance. An overall impairment of colonic propulsive activity may represent a major disease mechanism.Design 
    Case series.Setting 
    Tertiary university hospital.Subjects 
    Twenty-nine severely constipated patients with clinical and homogeneous features of slow-transit constipation that were unresponsive to conventional medical measures and 16 age-matched healthy volunteers.Interventions 
    Twenty-four–hour manometric recordings obtained in patients and controls to assess high- and low-amplitude colonic propulsive activity.Results 
    Compared with controls, patients showed heavily reduced high-amplitude propagated activity (average, <1 event per subject per day). No differences were found in low-amplitude propagated activity.Conclusions 
    Patients with severe constipation that is refractory to medical treatment may display an important reduction of colonic forceful propulsive activity. This may justify a surgical approach, which may offer the best results in such patients. It is, however, important to obtain thorough physiologic documentation before such a drastic approach is considered. The residual low-amplitude propulsive activity might represent a partially compensatory mechanism in these patients. Studies in more homogeneous groups of such patients are needed.