Glia A, Lindberg G
Dept. of Surgery, Karolinska Institutet, Huddinge University Hospital, Sweden.
Scand J Gastroenterol. 1998 Jan;33(1):55-62. doi: 10.1080/00365529850166211.
The results of subtotal colectomy for slow-transit constipation are unpredictable. Abdominal pain, distension, and bloating often persist after operation. To ascertain whether patients with slow-transit constipation may have a generalized intestinal motor disorder, we studied the antroduodenal motor activity in 20 consecutive patients with slow-transit constipation.
All patients underwent symptom registration, whole-gut transit time, anorectal manometry, electromyography of the anal sphincter, the balloon expulsion test, and defecography to characterize their constipation. The motor activity of the the gastric antrum and the proximal small bowel was monitored for 5 h, using a pneumohydraulic water-perfused manometry system with six channels.
Twelve patients (60%) had abnormal patterns of motor activity: abnormal propagation or configuration of phase III in 9 of 12 patients, bursts of non-propagated phasic activity in 8 of 12 patients, and sustained periods of intense phasic activity in 3 of 12 patients. One patient had generalized hypomotility with low-amplitude contractions. In addition, an abundance of so-called discrete clustered contractions was found in 6 of 20 patients.
A significant proportion of patients with slow-transit constipation have manometric findings that indicate a generalized motor disorder of the gut. The clinical significance of this finding is still unclear.
慢传输型便秘患者行结肠次全切除术后的效果难以预测。术后腹痛、腹胀常常持续存在。为确定慢传输型便秘患者是否存在全身性肠道运动障碍，我们对20例连续的慢传输型便秘患者的胃十二指肠运动活性进行了研究。
所有患者均进行症状记录、全肠道通过时间、肛门直肠测压、肛门括约肌肌电图、气囊排出试验及排粪造影，以明确其便秘情况。使用具有六个通道的气液灌注测压系统对胃窦和近端小肠的运动活性进行5小时监测。
12例患者（60%）运动活性模式异常：12例中有9例Ⅲ期传播或形态异常，12例中有8例出现非传播性阶段性活动爆发，12例中有3例出现持续性强烈阶段性活动。1例患者出现全身性运动减弱伴低幅度收缩。此外，20例患者中有6例发现大量所谓的离散成簇收缩。
相当一部分慢传输型便秘患者的测压结果表明存在全身性肠道运动障碍。这一发现的临床意义仍不明确。
