Clinical study of colonic transmission test in the diagnosis and classification of chronic functional constipation
Wang Yaqiong1,2, Ge Sitang3, Wang Qizhi1, Wang Dongsheng4, Zuo Lugen3, Cui Yanyan1
1Department of Gastroenterology, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China; 2Department of Gastroenterology, the Second Affiliated Hospital of Bengbu Medical College, Bengbu 233040, China; 3Department of Gastrointestinal Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China; 4Department of Radiology, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
Abstract：Objective To observe the clinical significance of colonic transmission test in the classification and treatment of chronic functional constipation.Methods From June 2017 to September 2018, the clinical data of 65 patients with chronic constipation in the First Affiliated Hospital of Bengbu Medical College were analyzed retrospectively. Among them, there were 17 males and 48 females aged 14-83 (49.8±16.2) years.The patients were given an oral gastrointestinal motility marker capsule under the condition of normal diet. Abdominal orthostatic tablets were taken 48 hours later to observe the distribution of barium ring markers in the segmented colon, so as to clarify the classification and guide the treatment of patients according to the classification. The patients with rectocele and prolapse were given circular resection and nailing of stapler and hemorrhoids; the patients with slow transit were given medication; the patients with mixed and normal transit constipation were given defecation training and medication. After 4 weeks of treatment, the stool characteristics, stool frequency and defecation difficulty of the patients were observed to evaluate the efficacy.Results Among 65 patients, 32 were slow transit type, 13 were outlet obstruction type, 2 were mixed type and 18 were normal colon transit function.After 4 weeks of treatment, the defecation frequency, 7 cases were lost and 58 cases were followed up successfully.Stool characteristics and defecation difficulty of 28 patients with slow transmission, 7 patients with outlet obstruction, 2 patients with mixed type and 16 patients with normal transmission were all improved, and the treatment was effective.Conclusions Colonic transmission test is of great value in the classification and treatment of chronic functional constipation, which can provide reference for the standardized clinical diagnosis and treatment of the disease.
王娅琼, 葛思堂, 王启之, 王东升, 左芦根, 崔艳艳. 结肠传输试验在慢性功能性便秘分型诊断及治疗中的应用[J]. 中华解剖与临床杂志, 2019, 24(3): 294-298.
Wang Yaqiong, Ge Sitang, Wang Qizhi, Wang Dongsheng, Zuo Lugen, Cui Yanyan. Clinical study of colonic transmission test in the diagnosis and classification of chronic functional constipation. Chinese Journal of Anatomy and Clinics, 2019, 24(3): 294-298.
van der Wilt AA, van Wunnik BP, Sturkenboom R, et al. Sacral neuromodulation in children and adolescents with chronic constipation refractory to conservative treatment[J]. Int J Colorectal Dis, 2016, 31(8): 1459-1466. DOI:10.1007/s00384-016-2604-8.
[5]
Black CJ, Ford AC. Chronic idiopathic constipation in adults: Epidemiology, pathophysiology, diagnosis and clinical management[J]. Med J Aust, 2018, 209(2): 86-91. DOI:10.5694/mja18.00241.
Sobrado CW, Neto IJFC, Pinto RA, et al. Diagnosis and treatment of constipation: a clinical update based on the Rome Ⅳ criteria[J]. J Coloproctol, 2018, 38(2): 137-144. DOI:10.1016/j.jcol.2018.02.003.
[8]
Chinzon D, Dias-Bastos TRP, Medeiros da Silva A, et al. Epidemiology of constipation in São Paulo, Brazil: a population-based study[J]. Curr Med Res Opin, 2015, 31(1): 57-64. DOI:10.1185/03007995.2014.973485.
[9]
Drossman DA, Hasler WL. Rome IV-functional GI disorders: disorders of gut-brain interaction[J]. Gastroenterology, 2016, 150(6): 1257-1261. DOI:10.1053/j.gastro.2016.03.035.
[10]
O'Donnell LJ, Virjee J, Heaton KW. Detection of pseudodiarrhoea by simple clinical assessment of intestinal transit rate[J]. BMJ, 1990, 300(6722): 439-440.
Karabudak E, Koksal E, MacIt MS. The relationship between body weight, fiber and fluid intake status and functional constipation in young adults[J]. Nutrit Food Sci, 2019, 49(1): 129-140. DOI:10.1108/nfs-03-2018-0083.
Mason MD, Ching CB, Clayton DB, et al. Diagnosis of constipation does not correlate with trans-abdominal ultrasound of rectal distention[J]. J Pediatr Urol, 2015, 11(3): 146.e1-e4. DOI:10.1016/j.jpurol.2015.01.017.
[18]
Beer-Gabel M, Carter D. Comparison of dynamic transperineal ultrasound and defecography for the evaluation of pelvic floor disorders[J]. Int J Colorectal Dis, 2015, 30(6): 835-841. DOI:10.1007/s00384-015-2195-9.
Bharucha AE, Pemberton JH, Locke GR 3rd. American Gastroenterological Association Technical Review on Constipation[J]. Gastroenterology, 2013, 144(1): 218-238. DOI:10.1053/j.gastro.2012.10.028.
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