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The colonic motility and classification of patients with slow transit constipation by high-resolution colonic manometry - 05/11/22

Doi : 10.1016/j.clinre.2022.101998 
Chen Xu a, 1, Jiying Cong a, 1, Tingting Liu a, Chenmeng Jiao b, Mingsen Li a, Yongjun Yu a, Zhao Zhang a, Shiwu Zhang c, , Yuwei Li a,
a Department of Colorectal Surgery, Tianjin Union Medical Center, 190 Jieyuan Road, Hongqiao, Tianjin, China 
b School of Graduate Studies, Tianjin University of Traditional Chinese Medicine, Tianjin, China 
c Department of Pathology, Tianjin Union Medical Center, 190 Jieyuan Road, Hongqiao, Tianjin, China 

Corresponding authors.

Highlights

Classification of patients with slow transit constipation.
The colonic motility of patients with slow transit constipation.
Reduced colonic motility by HRCM is observed in STC patients.
HRCM may be an assistant tool in characterizing, classifying the underlying pathophysiology and guiding clinical management for STC.

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Abstract

Background

This study aimed to evaluate the colonic motility of slow transit constipation (STC) patients using high-resolution colonic manometry (HRCM) and classify the patients’ subtypes to instruct treatment based on HRCM characteristics.

Methods

This study enrolled one hundred and twenty-six STC patients and 35 volunteers (healthy controls, HCs). Ambulatory HRCM was performed in all participants by placing a 36-sensor water-perfused probe up to the cecum. Quantitative and qualitative manometric analysis was conducted in the state of rest, postprandial, during sleep, and wakefulness.

Results

The occurrence rate and times of high amplitude propagated contraction (HAPC) in STC patients were lower than HCs. As for the HAPC contraction characteristics, the mean velocity was similar, contraction length, amplitude, area under the curve (AUC) of pressure wave, and duration were reduced in STC patients compared with HCs. In addition, the occurrence rate and times of low amplitude propagated contraction (LAPC) in STC patients were similar compared to HCs. There was no difference in HAPC occurrence, LAPC occurrence, and most detailed HAPC characteristics between STC patients ≤60 years and STC patients >60 years or between male STC patients and female STC patients. Based on the HRCM characteristics (including HAPC, neostigmine induced HAPC, LAPC, and waking/gastrocolic response), STC patients were classified into four types, respectively, with recommended treatment by clinical experience.

Conclusion

HRCM serves as a valuable tool in characterizing, classifying the pathophysiology, and guiding clinical management for STC.

El texto completo de este artículo está disponible en PDF.

Keywords : Slow transit constipation, High-resolution colonic manometry, Subtype, High amplitude propagated contraction, Low amplitude propagated contraction

Abbreviations : STC, HRCM, HAPC, LAPC, SPW, SD, AUC, HAPSs


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Vol 46 - N° 9

Artículo 101998- novembre 2022 Regresar al número
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