Abstract
A consecutive series of 58 patients with idiopathic constipation and 20 control subjects were studied by evacuation proctography and measurements were made of changes during rectal expulsion. A wide range was found in the control group. The anorectal angle, pelvic floor descent, and the presence or size of an anterior rectocele did not discriminate between the control and patient groups. Internal intussusception was rare. Among constipated patients, the only significant differences from normal were in the time taken to expel barium and the amount of barium remaining in the distal rectum. The majority of control subjects (15 of 20) evacuated most of the barium within 20 seconds whereas 45 of 58 constipated patietns took a longer time. Using the area of barium on a lateral view of the rectum as a measure, 19 of 20 control subjects evacuated at least 60 percent of the barium from the distal 4 cm of the rectum compared with only 25 of 58 patients. A varying degree of defectatory impairment was thus established among many patients with constipation. The patients were subdivided into those with a normal or abnormal whole gut transit rate as an indication of colonic function, and those who did or did not need to digitally evacuate the rectum as a clinical manifestation of an anorectal disorder. No obvious differences were found between these subgroups using the parameters measured.
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References
Drossman DA, Sandler RS, McKee DC, Lovitz AJ. Bowel patterns among subjects not seeking health care. Gastroenterology 1982;83:529–34.
Preston DM, Lennard-Jones JE. Severe chronic constipation of young women: idiopathic slow transit constipation. Gut. 1986; 27:41–8.
Turnbull GK, Lennard-Jones JE, Bartram CI. Failure of rectal expulsion as a cause of constipation: why fibre and laxatives sometimes fail. Lancet 1986;1:767–9.
Preston DM, Lennard-Jones JE, Thomas BM. The balloon proctogram. Br J Surg 1983;71:29–32.
Preston DM, Lennard-Jones JE. Anismus in chronic constipation. Dig Dis Sci 1985;30:413–8.
Barnes PR, Lennard-Jones JE. Balloon expulsion from the rectum in constipation of different types. Gut 1985;26:1049–52.
Reid NW, Timms JM, Barfield LJ, Donnelly TC, Bannister JJ. Impairment of defecation in young women with severe constipation. Gastroenterology 1986;90:53–60.
Shouler P, Keighley MR. Changes in colorectal function in severe idiopathic chronic constipation. Gastroenterology 1986;90:414–20.
Kuijpers HC, Bleijenberg G. The spastic pelvic floor syndrome: a cause of constipation. Dis Colon Rectum 1985;28:660–72.
Womack NR, Williams NS, Holmfield JH, Morrison JF, Simpkins KC. New method for the dynamic assessment of anorectal function in constipation. Br J Surg 1985;72:994–8.
Loening-Baucke V. Anorectal manometry and defecation studies in childhood encopresis. Dig Dis Sci 1985;30:A25.
Meunier P. Rectoanal dysnergia in constipated children. Dig Dis Sci 1985;30:A29.
Mahieu P, Pringot J, Bodart P. Defecography: I. Description of a new procedure and results in normal patients. Gastrointest Radiol 1984;9:247–51.
Bartram CI, Turnbull GK, Lennard-Jones JE. Evacuation proctography: an investigation of rectal expulsion in 20 subjects without defaecatory disturbance. Gastrointest Radiol 1988;13:79–80.
Bartolo DC, Roe AM, Virjee J, Mortensen MJ. Evacuation proctography in obstructed defaecation and rectal intussusception. Br J Surg 1985;72(suppl):111–6.
Hoffman MJ, Kodner IJ, Fry RD. Internal intussusception of the rectum. Dis Colon Rectum 1984;27:435–41.
Martelli H, Devroede G, Arhan P, Duguay C, Dornic C, Faverdin C. Some parameters of large bowel motility in normal man. Gastroenterology 1978;75:612–8.
Hinton JM, Lennard-Jones JE, Young AC. A new method for studying gut transit times using radio-opaque markers. Gut 1969;10:942–7.
Ekberg O, Nylander G, Fork F-T. Defecography. Gastrointest Radiol 1984;9:253–61.
Hero M, Arhan P, Devroede G, et al. Measuring the ano-rectal angle. J Biomed Eng 1985;7:321–5.
Colton T. Statistics in medicine. Boston: Little, Brown & Co., 1974.
Thompson WG, Heaton KW. Functional bowel disorders in apparently healthy people. Gastroenterology 1980;79:283–8.
Burkitt DP, Walker AR, Painter NS. Dietary fiber and disease. JAMA 1974;229:1068–74.
Shorvon PJ, McHugh F, Somers S, Stevenson GW. Defecographic findings in young healthy volunteers. Gut 1987;28:A1361–2.
Roe AM, Bartolo DC, Mortensen NJ. Techniques in evacuation proctography in the diagnosis of intractable constipation and related disorders. J R Soc Med 1986;79:331–3.
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Turnbull, G.K., Bartram, C.I. & Lennard-Jones, J.E. Radiologic studies of rectal evacuation in adults with idiopathic constipation. Dis Colon Rectum 31, 190–197 (1988). https://doi.org/10.1007/BF02552545
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DOI: https://doi.org/10.1007/BF02552545