Role of colonic motility in guiding therapy in patients with constipation

Digestive Diseases
W J Snape

Abstract

Constipation is a common condition defined by less than three bowel movements per week. Often constipation is secondary to altered motility of the colon. Tests that measure colonic motility lead the clinician to appropriate therapy. Colonic transit measured with either radionuclides or radio-opaque markers determine whether the transit through the colon is truly slow, and then identify the potential region of the colon that impedes the movement of intraluminal contents. Patients with normal colonic transit do not require further evaluation of their colonic motor function. Colonic and anorectal manometry differentiate patients in to 3 groups: (1) functional anal outlet obstruction; (2) uncoordinated distal colonic phasic contractions, and (3) colonic inertia. Functional outlet obstruction may be treated successfully by increasing the water content of their stools and biofeedback. Antispasmodics including anticholinergics, nitrates and calcium channel blockers may decrease the functional obstruction caused by phasic colonic contractions. The prokinetics such as cisapride have successfully improved constipation due to colonic inertia, Parkinson's disease or spinal cord injury as well as idiopathic inertia. Occasionally patients wi...Continue Reading

Citations

Jul 1, 2005·Digestive Diseases and Sciences·Henry C LinUNKNOWN AMS Task Force Committee on Gastrointestinal Transit
Sep 28, 2007·Current Treatment Options in Gastroenterology·Nader N Youssef
Dec 2, 2014·Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association·Ramesh R RaiNirmal Kumar
Apr 11, 2007·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·G CappelloL Marzio
Feb 14, 2007·Clinical Therapeutics·Anastasia Rivkin, Larisa Chagan
Mar 30, 2010·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·S S C RaoR Mudipalli
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Jan 25, 2017·Current Treatment Options in Gastroenterology·Jenna Koliani-Pace, Brian E Lacy
Dec 23, 2004·Chinese Journal of Digestive Diseases·Guan Ying Xiong, Zhi Quan Zhao
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