A Case of Constipation with Decreased Rectal Sensation Improved by Electrical Stimulation Therapy Alone / 대한소화관운동학회지

ABSTRACT

Patients with intractable constipation often complain of social, physical and psychological stress. Recently, biofeedback therapy is widely used in the management of intractable constipation and improve the defecation act, particularly in cases of constipation associated with pelvic floor dyssynergia. However, some of constipated patients show only decreased rectal sensation and increased rectal compliance on the anorectal function tests. It is unclear whether the decreased rectal sensation is a cause or outcome of constipation and not known how to treat such cases. We recently experienced a 25-year-old female patient who complained of constipation. She had intractable constipation, which made her attempt a suicide. Colon transit time study and defecogram showed nonspecific findings. Her anorectal manometric findings were within normal ranges except rectal sensation and compliance. Rectal volume for desire and urge to defecate, and maximal tolerable volume were markedly increased and compliance was impossible to measure. She was treated by electrical stimulation therapy. After electrical stimulation therapy, her constipation symptoms improved dramatically. Furthermore, the desire and urge volume were decreased and the compliance became calculated. We report this constipation case with decreased rectal sensation and increased rectal compliance possibly treated by electrical stimulation therapy.