Meyer-Wyss B
Abteilung für Gastroenterologie, Kantonsspital, Basel.
Ther Umsch. 1991 Jul;48(7):488-93.
The investigation of colonic motility is a difficult task. Little is known on the myoelectrical activity of the human colon or on physiologic manometric findings. Scintigraphic studies have been performed to investigate the movement of colonic contents and have revealed that the ascending colon mainly acts as a storage area. Because physiologic data are rare, the interpretation of findings in patients with distinct bowel symptoms may be very difficult to interpret. Only a part of the patients who present with chronic obstipation have colonic inertia which is characterized by a slow transit through the entire colon. Other patients may have anismus, i.e. a disturbance of the highly complex activity of defecation. Elderly patients may have diminished rectal sensitivity to dilation and thus do not feel the urge the defecate. Patients with irritable bowel syndrome have been extensively investigated for underlying motility disorders. In spite of ample data the exact pathogenesis remains unknown. Furthermore, it has become clear that patients with the irritable bowel syndrome not only have irritable guts but also an irritable personality. Treatment of chronic constipation is difficult. Bulking agents and osmotically active laxatives often fail to give a satisfactory result. Patients with irritable bowel syndrome may benefit from both bulking agents, but tranquilizers may be helpful as well.
结肠动力的研究是一项艰巨的任务。关于人类结肠的肌电活动或生理测压结果，我们知之甚少。已经进行了闪烁扫描研究以调查结肠内容物的运动，并发现升结肠主要起储存区域的作用。由于生理数据稀少，对有明显肠道症状患者的检查结果进行解读可能非常困难。只有一部分表现为慢性便秘的患者患有结肠惰性，其特征是整个结肠的传输缓慢。其他患者可能患有排便障碍，即排便这一高度复杂活动的紊乱。老年患者直肠对扩张的敏感性可能降低，因此没有排便的冲动。肠易激综合征患者已被广泛研究其潜在的动力障碍。尽管有大量数据，但确切的发病机制仍然未知。此外，已经很清楚的是，肠易激综合征患者不仅肠道易激，而且性格也易激。慢性便秘的治疗很困难。容积性泻药和渗透性泻药往往不能取得令人满意的效果。肠易激综合征患者可能从这两种容积性泻药中获益，而镇静剂可能也有帮助。
