The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipation

Detalhes bibliográficos
Autor(a) principal: Quaresma,Abel Botelho
Data de Publicação: 2020
Outros Autores: Baptistella,Antuani Raphael, Rossoni,Carina
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Journal of Coloproctology (Rio de Janeiro. Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632020000300247
Resumo: Abstract Introduction: Anorectal physiology tests are indicated for patients who have refractory symptoms of constipation, but the best sequence of investigation remains controversial. Objective: To evaluate the influence of colonic transit time and anorectal manometry in the diagnosis of chronic constipation in adults. Method: This was a study of adult patients with constipation at a private clinic in a city in southern Brazil, from January 1, 2009 to December 31, 2018. Those who showed warning signs were referred for colonoscopy and those with any anatomical alterations were excluded. The patients received 10 g of psyllium and those who remained symptomatic after three weeks were referred for functional assessment with colonic transit time (CTT). Those who presented outlet obstruction in the colonic transit time were referred to anorectal manometry. Results: Of the 889 adult patients surveyed, 227 were included. Of the 216 who completed the study, 167 responded to primary treatment. Forty-nine underwent CTT. In these, 16 had normal colonic transit time and 33 were altered. In those with altered colonic transit time, eight had a pattern of colonic inertia and 25 had an obstruction pattern. The 25 patients with an outlet obstruction pattern underwent anorectal manometry. Eighteen had signs of paradoxical contracture of the puborectal muscle (PPRC) and seven did not. Conclusion: This study concluded that anorectal physiology exams contribute to the diagnosis of constipation, often changing the behavior. These exams should be performed whenever the patient does not respond to hygienic changes and fiber replacement.
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spelling The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipationConstipationGastrointestinal motilityGastrointestinal transitManometryDigestive system phenomenaAbstract Introduction: Anorectal physiology tests are indicated for patients who have refractory symptoms of constipation, but the best sequence of investigation remains controversial. Objective: To evaluate the influence of colonic transit time and anorectal manometry in the diagnosis of chronic constipation in adults. Method: This was a study of adult patients with constipation at a private clinic in a city in southern Brazil, from January 1, 2009 to December 31, 2018. Those who showed warning signs were referred for colonoscopy and those with any anatomical alterations were excluded. The patients received 10 g of psyllium and those who remained symptomatic after three weeks were referred for functional assessment with colonic transit time (CTT). Those who presented outlet obstruction in the colonic transit time were referred to anorectal manometry. Results: Of the 889 adult patients surveyed, 227 were included. Of the 216 who completed the study, 167 responded to primary treatment. Forty-nine underwent CTT. In these, 16 had normal colonic transit time and 33 were altered. In those with altered colonic transit time, eight had a pattern of colonic inertia and 25 had an obstruction pattern. The 25 patients with an outlet obstruction pattern underwent anorectal manometry. Eighteen had signs of paradoxical contracture of the puborectal muscle (PPRC) and seven did not. Conclusion: This study concluded that anorectal physiology exams contribute to the diagnosis of constipation, often changing the behavior. These exams should be performed whenever the patient does not respond to hygienic changes and fiber replacement.Sociedade Brasileira de Coloproctologia2020-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632020000300247Journal of Coloproctology (Rio de Janeiro) v.40 n.3 2020reponame:Journal of Coloproctology (Rio de Janeiro. Online)instname:Sociedade Brasileira de Coloproctologia (SBCP)instacron:SBCP10.1016/j.jcol.2020.05.014info:eu-repo/semantics/openAccessQuaresma,Abel BotelhoBaptistella,Antuani RaphaelRossoni,Carinaeng2020-08-12T00:00:00Zoai:scielo:S2237-93632020000300247Revistahttp://www.scielo.br/scielo.php?script=sci_serial&pid=2237-9363&lng=pt&nrm=isohttps://old.scielo.br/oai/scielo-oai.php||sbcp@sbcp.org.br2317-64232237-9363opendoar:2020-08-12T00:00Journal of Coloproctology (Rio de Janeiro. Online) - Sociedade Brasileira de Coloproctologia (SBCP)false
dc.title.none.fl_str_mv The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipation
title The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipation
spellingShingle The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipation
Quaresma,Abel Botelho
Constipation
Gastrointestinal motility
Gastrointestinal transit
Manometry
Digestive system phenomena
title_short The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipation
title_full The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipation
title_fullStr The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipation
title_full_unstemmed The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipation
title_sort The real impact of colonic transit time and anorectal manometry in the diagnosis of adult patients with chronic constipation
author Quaresma,Abel Botelho
author_facet Quaresma,Abel Botelho
Baptistella,Antuani Raphael
Rossoni,Carina
author_role author
author2 Baptistella,Antuani Raphael
Rossoni,Carina
author2_role author
author
dc.contributor.author.fl_str_mv Quaresma,Abel Botelho
Baptistella,Antuani Raphael
Rossoni,Carina
dc.subject.por.fl_str_mv Constipation
Gastrointestinal motility
Gastrointestinal transit
Manometry
Digestive system phenomena
topic Constipation
Gastrointestinal motility
Gastrointestinal transit
Manometry
Digestive system phenomena
description Abstract Introduction: Anorectal physiology tests are indicated for patients who have refractory symptoms of constipation, but the best sequence of investigation remains controversial. Objective: To evaluate the influence of colonic transit time and anorectal manometry in the diagnosis of chronic constipation in adults. Method: This was a study of adult patients with constipation at a private clinic in a city in southern Brazil, from January 1, 2009 to December 31, 2018. Those who showed warning signs were referred for colonoscopy and those with any anatomical alterations were excluded. The patients received 10 g of psyllium and those who remained symptomatic after three weeks were referred for functional assessment with colonic transit time (CTT). Those who presented outlet obstruction in the colonic transit time were referred to anorectal manometry. Results: Of the 889 adult patients surveyed, 227 were included. Of the 216 who completed the study, 167 responded to primary treatment. Forty-nine underwent CTT. In these, 16 had normal colonic transit time and 33 were altered. In those with altered colonic transit time, eight had a pattern of colonic inertia and 25 had an obstruction pattern. The 25 patients with an outlet obstruction pattern underwent anorectal manometry. Eighteen had signs of paradoxical contracture of the puborectal muscle (PPRC) and seven did not. Conclusion: This study concluded that anorectal physiology exams contribute to the diagnosis of constipation, often changing the behavior. These exams should be performed whenever the patient does not respond to hygienic changes and fiber replacement.
publishDate 2020
dc.date.none.fl_str_mv 2020-09-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632020000300247
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1016/j.jcol.2020.05.014
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Coloproctologia
publisher.none.fl_str_mv Sociedade Brasileira de Coloproctologia
dc.source.none.fl_str_mv Journal of Coloproctology (Rio de Janeiro) v.40 n.3 2020
reponame:Journal of Coloproctology (Rio de Janeiro. Online)
instname:Sociedade Brasileira de Coloproctologia (SBCP)
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reponame_str Journal of Coloproctology (Rio de Janeiro. Online)
collection Journal of Coloproctology (Rio de Janeiro. Online)
repository.name.fl_str_mv Journal of Coloproctology (Rio de Janeiro. Online) - Sociedade Brasileira de Coloproctologia (SBCP)
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