Search

Chronic intractable constipation is a disease afflicting predominantly young women, in which spontaneous bowel movements occur only once or twice per month. In some women, there is a deformation of the pelvis that results in a mechanical impediment to the passage of feces through the large intestine. In others, there is no apparent cause for the disorder, and these women are generally resistant to conventional medical treatment. Surgical treatment, removal of part of the colon, is usually the only resort, and it is not always successful. In order to investigate the neuromuscular basis of this disorder, eight women with chronic intractable constipation and 12 normal controls were studied. Mechanical sensors were placed in the colon, rectum, and anus of each subject, and intestinal neuromuscular activity was automatically recorded with a portable encoder box and cassette recorder. A distinctive pattern of pressure changes (known as sampling responses) was seen in the normal controls and consistent with previously reported data. These sampling responses occurred at a greatly reduced frequency in the constipated subjects. In addition, rectal motor complexes (wavelike contractions of the rectum necessary for normal defecation) were greatly reduced in amplitude in the constipated subjects. These results suggest that reduced transit of feces from the colon to the rectum may be part of the underlying cause of the constipation, and that a motor neuropathy (defective nerve supply to the large intestine) may be responsible. (Consumer Summary produced by Reliance Medical Information, Inc.)