Colonic response to food in constipation

被引:22
作者
Bouchoucha, Michel
Devroede, Ghislain
Faye, Alain
Le Toumelin, Philippe
Arhan, Pierre
Arsac, Michel
机构
[1] Univ Paris 05, Hop Broussais, Lab Physiol Digest, F-75014 Paris, France
[2] Hop Avicenne, F-93009 Bobigny, France
[3] CHUS F, Dept Chirurg, Sherbrooke, PQ J1H 5N4, Canada
[4] CHU, Serv Physiol, F-14033 Caen, France
关键词
human; transit time; physiology; radiopaque markers;
D O I
10.1007/s00384-005-0787-5
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Colonic response to food is possibly abnormal in constipation. Methods: The colonic response to food was evaluated in 323 patients and 60 healthy subjects by following the movements of radiopaque markers after ingestion of a standard 1,000-cal test meal. Constipated patients were divided into four groups: one with a normal, and three with a delayed colorectal transit time. When the delay was found mainly in the ascending colon, the group was labeled as suffering from "colonic inertia". In "hindgut dysfunction", the delay was predominantly found in the descending colon, whereas the term "outlet obstruction" was reserved for constipated patients whose major site of delay was the rectosigmoid area. Colonic response to food was quantified by evaluating the variation of markers in a given abdominal region and the evolution of the geometric center on the entire plain film of the abdomen. Results: Emptying of the caecum-ascending colon and filling of the rectosigmoid area characterize the colonic response to food in healthy subjects. Constipated patients also filled the rectosigmoid, but different patterns were found in the colon. In constipated patients with transit in the normal range, there was a frequent (41%) absence of colonic response to food as compared to controls (13%) and constipated patients with delayed transit (p < 0.0001). The response to food of patients with colonic inertia was similar to that of healthy subjects in terms of distal progression, but less marked. The hindgut dysfunction group emptied the entire left colon but failed to empty the caecum and ascending colon. In the outlet obstruction group, there was no distal progress of the geometric center after meal. Conclusions: Abnormal colonic response to food is frequently found in constipated patients, with different patterns according to the type of constipation.
引用
收藏
页码:826 / 833
页数:8
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