The study on the colon and anorectal motility in the elderly patients with chronic functional constipation / 中华老年医学杂志

ABSTRACT

Objective To investigate the dynamic abnormality of colon and anorectum in elderly patients with chronic functional constipation(CFC). Methods Forty-two elderly patients with CFC and twenty elderly healthy controls were selected. Total and segmental colonic transit time(CTT) were assessed radiographically by using oral radiopaque markers. Eight-lead water perfusion pressure measurement system and balloon were used to test the pressure and the perception threshold values of anus and rectum. Results (1) Total colonic transit time (TCTT) and sigmoid-rectum transit time (SRTT) were (49.0±16.4) h and (20.1±13.5) h in elderly patients with CFC, which were significantly prolonged compared with the controls [(25.2±7.7) h and (7.8±4.1) h, t=6.16 and 3.97,both P<0.05]. (2) The pressure of anal canal during defecation was (39.6±15.7) mmHg in elderly patients with CFC and (17.6±9.3) mm Hg in controls (t=5.79, P<O.05). The lowest volume threshold and the maximal tolerance volume of rectal perception to balloon distention were (49.2±10.5) ml and (175.2±52.6) ml in elderly patients with CFC, which were higher than the controls[(33.6±8.5) ml and (123.4±39.1) ml, t=5.79 and 3.91, both P<0.05]. The rate of rectoanal inhibitory reflex (RAIR) was 59.5% and 85.0% in elderly patients with CFC and controls, respectively(x2 =4.03,P<O.05). Conclusions The CTT and SRTT are prolonged obviously in elderly patients with CFC. The anorectal dynamic changes include decreased sensibility of rectum, lower rate of RAIR and anorectal dyssynergia during defecation. The test of CTT and anorectal manometry provide evidence for the classification and treatment of constipation.