The Study On Anorectal Motility And Rectal Visceral Perception And Biofeedback For Functional Constipation

Objective :To study anorectal motility and rectal visceralperception to balloon distention in patients between obstructiveconstipation (OOC)andslow trnsit constipation(STC). In themeantime,to assess the clinic effect of biofeedback treatmentand drug for two kinds of constipation.Methods : Anorectal motility and rectal visceralperception to balloon distention and ice water were measuredwith manometry system (MMS, dutch) between 46 FC patientsand 22healthy patients were also studied as controls.46 FCpatients were made checking colonic transit time beforetherpathy,then they were outlet obstructive constipation(OOC),slow transit constipation(STC)and mixed constipation .15patients of OOC all were taken the biofeedbacktraining ,15patients of STC enlisted to biofeedback traning forfour weeks and others were tegaserod 6 mg b.i.d for sametime,followed by a 4-week withdraw time.Results There were no significant differences in rectalresting pressure , anal resting pressure ,and maximum squeezepressure between OOC and STC patients patients group ( P > 0.05) . only for minimu relaxation volume to elicit rectal analinhibitory reflex (RAIR),OOCgroups is higher than STC groups(P < 0. 05). The rectal primary sensitivity and maximumtolerance to balloon distention in both patients were nosignificant differences .for biofeedbacks , the symptoms gotimproved (P < 0. 05 ) . in patients with outlet obstructive , forpatients with slow transit ,drug treatment is better than otherswith biofeedbacks for long terms .Conclusion Functional constipation patients may be alsorelated to low higher tolerance ,as well as the fact that internalanal sphincter ( IAS) could not relax in time to expanding ofrectum. Biofeedback treatment is effective for OOC forms ofconstipation.tegaserod can be one of the most important ways tocure functional constipation with STC. ARM can improve theaccurate diagnosis rate of OOC pattern,and GITT is helpful inthe confirmation of STC pattern. Proper categorization of themotor dysfunctional patterns is important in guiding theclinical management of chronic constipation .