Chang Hye-Sook, Myung Seung-Jae, Yang Suk-Kyun, Yoon In Ja, Kwon Oh Ryoun, Jung Hwoon-Yong, Hong Weon-Seon, Kim Jin-Ho, Min Young Il, Yu Chang Sik
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Dis Colon Rectum. 2004 Jun;47(6):933-6. doi: 10.1007/s10350-004-0521-3. Epub 2004 Apr 13.
Patients with intractable constipation often complain of social, physical, and psychologic stress. Recently, biofeedback therapy has been widely used for the management of intractable constipation, particularly in cases of constipation associated with pelvic floor dyssynergia. However, some constipated patients often complain of absent or diminished sense of wanting to defecate. It is unclear whether impaired rectal sensation is a cause or outcome of constipation and what specific treatment is available for these patients. We treated a 25-year-old female patient who complained of intractable constipation for ten years. Colon transit time study and defecography showed nonspecific findings. Her anorectal manometric findings were within normal ranges with the exception of impaired rectal sensation. Rectal sensory threshold volumes for desire and urge to defecate and maximal tolerated volume were greatly increased. She was treated by electric stimulation therapy for the purpose of improving impaired rectal sensory function. After 14 sessions of electric stimulation therapy, her constipated symptoms improved dramatically. Furthermore, the desire and urge threshold volumes were remarkably decreased. We report this case of constipation with impaired rectal sensation possibly treated by electric stimulation therapy.
顽固性便秘患者常伴有社交、身体和心理压力。近来，生物反馈疗法已广泛应用于顽固性便秘的治疗，尤其是与盆底失协调相关的便秘。然而，一些便秘患者常主诉便意缺失或减弱。目前尚不清楚直肠感觉受损是便秘的原因还是结果，以及针对这些患者有哪些具体的治疗方法。我们治疗了一名25岁女性患者，她主诉顽固性便秘已达十年。结肠运输时间研究和排粪造影结果均无特异性。除直肠感觉受损外，她的肛门直肠测压结果均在正常范围内。直肠对便意和排便冲动的感觉阈值容积以及最大耐受容积均大幅增加。为改善受损的直肠感觉功能，对她进行了电刺激治疗。经过14次电刺激治疗后，她的便秘症状显著改善。此外，便意和排便冲动阈值容积也明显降低。我们报告了这例可能通过电刺激疗法治疗的伴有直肠感觉受损的便秘病例。
