Merkel I S, Locher J, Burgio K, Towers A, Wald A
Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania.
Am J Gastroenterol. 1993 Nov;88(11):1854-9.
To characterize colorectal physiologic parameters and psychological profiles in subjects > or = 60 yr with chronic constipation who have not sought medical advice.
Colorectal physiologic studies and psychologic profiles were obtained in 18 self-identified constipated subjects and 17 nonconstipated control subjects. Constipation was defined as two or fewer bowel movements/week and/or defecatory difficulty for at least 6 months. All subjects underwent colonic transit with radiopaque markers, anorectal manometry and completed a self rated inventory assessing psychological distress (SCL-90-R).
Slow colonic transit occurred in five constipated subjects. Pelvic floor dyssynergia and/or increased rectal compliance were found in nine subjects versus only two controls. One-third of constipated subjects scored in the top 10th percentile for global psychologic distress with higher scores for somatization, depression, and anxiety than control subjects. Neither physiologic nor psychologic abnormalities were predictable on the basis of patterns of bowel complaints.
Colorectal physiologic and psychologic dysfunctions are common in elderly constipated subjects who do not seek medical attention for bowel dysfunction.
对60岁及以上未寻求医疗建议的慢性便秘患者的结直肠生理参数和心理状况进行特征描述。
对18名自我认定为便秘的受试者和17名非便秘对照受试者进行了结直肠生理研究和心理状况评估。便秘定义为每周排便次数少于两次和/或排便困难至少6个月。所有受试者均接受了不透X线标志物的结肠运输试验、肛门直肠测压，并完成了一份评估心理困扰的自评量表（SCL-90-R）。
5名便秘受试者出现结肠运输缓慢。9名受试者存在盆底协同失调和/或直肠顺应性增加，而对照组仅有2名。三分之一的便秘受试者在总体心理困扰方面得分位于前10%，在躯体化、抑郁和焦虑方面的得分高于对照受试者。根据排便主诉模式无法预测生理或心理异常情况。
在因肠道功能障碍未寻求医疗关注的老年便秘患者中，结直肠生理和心理功能障碍很常见。
