Colonic Lymphoid Aggregates in Slow Transit Constipation

Abstract

Information available on colonic lymphoid aggregates, apart from data of patients with inflammatory conditions, is scarce in other pathologic conditions. We investigated colonic lymphoid aggregates in patients with severe slow transit constipation, unresponsive to conventional therapeutic measures, and undergoing surgery for relief of their symptoms. Tissues from 27 patients with intractable slow transit constipation were obtained and compared with 10 controls. The number, diameter, lymphocyte distribution, and proliferative index were calculated and compared in both groups. Constipated patients displayed a significantly increased number of colonic lymphoid aggregates compared with controls. No differences were found concerning the other variables. The increase of colonic lymphoid aggregates found in severely constipated patients may represent a protective mucosal mechanism toward the chronic fecal stasis.

Searching for a definition for pharmacologically refractory constipation: A systematic review

“…Surgery for constipation would normally be carried out on patients with the most refractory symptoms. In this review, 48 studies involving surgical treatment of constipation were included: 32 of which were surgical series, while 16 were studies on colonic tissue obtained at colectomy . Seven of the pathological series came from one center and three from another group …”

“…In this review, 48 studies involving surgical treatment of constipation were included: 32 of which were surgical series, 6,[14][15][16]21,[26][27][28][29][30][32][33][34][35]37,39,41,43,45,46,48,49,[51][52][53][54]56,[58][59][60]63 while 16 were studies on colonic tissue obtained at colectomy. [8][9][10][11][17][18][19][20]22,23,25,31,36,44,62,66 Seven of the pathological series came from one center 10,11,19,…”

“…Sixteen studies 6,8,14,21,27,[32][33][34]39,41,43,48,49,54,58,60 did not specify the duration of constipation in their patients although one author described it as "a long time" 43 and another "longstanding". 8 The constipation was said to be severe in 11 studies, 18,20,21,27,33,39,41,43,49,53,56 intractable in 9 studies, [8][9][10]16,28,35,45,48,60 severely intractable in 5 studies, 11,19,22,25,44 and refractory in 7 studies. 15,29,37,59,63,65,66 The severity of the constipation was not qualified in 16 ...…”

Yangyin Runchang Decoction Improves Intestinal Motility in Mice with Atropine/Diphenoxylate‐Induced Slow‐Transit Constipation

“…Li et al [ 18 ] used the iTRAQ labeling technique coupled with two-dimensional liquid chromatography-tandem mass spectrometry to analyze colon tissue from 43 patients with STC, and identified inflammatory cell infiltration. Villanacci et al [ 19 ] found that patients with intractable STC had a significantly greater number of colonic lymphoid aggregates than those in the control specimens. The number of colonic mast cells, a type of inflammatory cell, was shown to be elevated in severely constipated patients [ 20 ].…”

Pathology reports solve "new bowel disease" riddle

“…31 But such prosaic observations would not have helped the lawsuits-for which Wakefield was hired before any child was referred, and which in the UK paid him more than £400 000. Five other Royal Free doctors-Davies and Dhillon were not among them-shared more than £100 000 to back him.…”