The importance of defecography in the assessment of the etiology of chronic constipation: An analysis of 630 patients

Abstract

Objective: Chronic constipation is an entity with a high prevalence in the community. In our study, we analyzed the importance of defecography in the assessment of the etiology of chronic constipation. Material and Methods:Patients who were admitted to our hospital outpatient general surgery clinic with complaints of constipation between July 2010 and January 2014, and who had their demographic data and defecography results recorded were included in the study. The demographic data of patients who underwent defecography and their results were recorded along with patient gender and age. Results:The defecography was abnormal in 573 patients (90.9%) while it was normal in 57 patients (9.1%). Conclusion:Defecography is the current standard method of examination in etiological investigations for constipation, and it should be performed in each patient with a diagnosis of chronic constipation.Key Words: Chronic constipation, defecography, rectocele INTRODUCTIONChronic constipation is a frequent condition (1, 2). Colonic transit time measurement, defecography and anal manometry can all be used to determine the etiology of chronic constipation (3). Although it is assumed that the measurement of the colonic transit time distinguishes between slow passage constipation and outlet obstruction, the test may not be helpful in differentiation of these causes depending on the patient's diet (4).Defecography may enable the identification of pathologies that cause outlet obstruction (5). There are studies supporting the usefulness of defecography in demonstrating the etiology in patients with normal colonic transit time and those with outlet obstruction (6).In our study, we investigated the requirement for defecography, independent of other etiological examination tests, for patients diagnosed with chronic constipation according to the Rome III criteria. MATERIAL AND METHODSPatients who presented to the general surgery outpatient clinic of our hospital between July 2010 and January 2014 were included in the study. The diagnosis of constipation was made according to the Rome III criteria. The patients with a Rome III assessment score of 2 and above underwent defecography in order to investigate the etiology of constipation.As part of the etiological examination for chronic constipation, the patients initially received a test demonstrating the colonic transit time. Patients who were diagnosed with obstructive defecation or with a normal colonic transit time underwent defecography in the second stage.Defecography was conducted in the endoscopy unit of our hospital by general surgeons. For the procedure, the contrast material was mixed with starch flour to provide a consistency similar to stool, and was administered via 50 cc cone tip injectors. Then, a series of images were captured while the patients were being asked to repeat the straining-retaining processes for three times.Defecography results were recorded as well as gender and age. RESULTSBetween July, 2010 and January, 2014, 715 patients presented to the general surgery outpat...

Defecographic Findings in Patients with Severe Idiopathic Chronic Constipation

“…In a study by Bozkurt and his colleagues, anterior rectocele was observed in 78.6% of 585 females, out of the total 630 patients. 34 Our finding is not surprising because it has been reported that the main reason of this abnormality is the loss of vaginal support to the endopelvic fascia. In 9 children (75%), the change in treatment improved the symptoms.…”

Systematic Characterization of Defecographic Abnormalities in a Consecutive Series of 827 Patients With Chronic Constipation

“…Only 3 of these exclusively focused on patients with constipation. [31][32][33] Others included a mixture of defecation disorders without providing stratified results on constipated patients. Emblematic is the article by Mellgren et al 8 on 2816 patients (superseding Ahlbäck and Broden 30 ), two thirds of whom were constipated (Table 4).…”