Spiller R C
Division of Gastroenterology, University Hospital, Nottingham, UK.
Eur J Gastroenterol Hepatol. 1999 Jul;11(7):693-6. doi: 10.1097/00042737-199907000-00001.
Although constipation is common only a small fraction meet the criteria of slow transit constipation. Those that do are resistant to treatment and present a significant clinical problem to the physician and surgeon. Evidence has been accumulating over many years that the impaired colonic motility is part of a generalized motility defect. There are several reports of oesophageal dysmotility, delayed gastric emptying and slow small bowel transit. These abnormalities are not secondary to a distended colon since they are still seen after colonic cleansing and even after colectomy. The manometric abnormalities of small bowel motility are hard to assess unless done over a prolonged period (24 h) because of the great variability observed. The clinical picture of slow transit constipation is quite different from chronic intestinal pseudo-obstruction and the manometric abnormalities are much less obvious. The possibility of an underlying autonomic disturbance warrants further study.
尽管便秘很常见，但只有一小部分符合慢传输型便秘的标准。符合标准的患者对治疗有抵抗性，给内科医生和外科医生带来了重大的临床问题。多年来不断有证据表明，结肠动力受损是全身性动力缺陷的一部分。有几篇关于食管动力障碍、胃排空延迟和小肠传输缓慢的报道。这些异常并非结肠扩张的继发表现，因为在结肠清洁后甚至结肠切除术后仍可观察到。由于观察到的变异性很大，除非进行长时间（24小时）的测量，否则小肠动力的测压异常很难评估。慢传输型便秘的临床表现与慢性假性肠梗阻有很大不同，测压异常也不那么明显。潜在自主神经紊乱的可能性值得进一步研究。
