Background: 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.
Methods: 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.
Results: 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.
Conclusion: 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.