Upper gastrointestinal motor activity in patients with slow-transit constipation

Abstract

Recent evidence indicates that patients complaining of severe chronic idiopathic constipation may have motor abnormalities not limited to the colon. We studied by manometric means gastric and small bowel motility in a homogeneous group of patients with chronic idiopathic constipation, ie, the slow transit type. Twenty-one patients were recruited for the study and compared to 33 healthy subjects. Manometric examination was carried out for about 5 hr fasting and 1 hr after a standard meal. Analysis of the manometric tracings revealed during fasting no abnormalities in number and configuration of migrating motor complex with respect to controls. However, in 70% of patients motor abnormalities were detected, represented by bursts of nonpropagated contractions and discrete clustered contractions. After feeding, the patient group displayed a significantly shorter antral motor response to the meal with respect to controls; moreover, intestinal bursts of nonpropagated contractions were found in 19% of patients, and 14% of them had an early return of the activity fronts. We conclude that patients with slow transit constipation frequently display motor abnormalities of the upper gut. These findings further strengthen the concept that this condition may represent a panenteric disorder.

Electroacupuncture improves rectal distension-induced delay in solid gastric emptying in dogs

“…gastrointestinal motility; acupuncture; gastroparesis; constipation PATIENTS WITH CHRONIC, IDIOPATHIC, slow-transit constipation and constipation-dominant irritable bowel syndrome (IBS-C) frequently complain of upper abdominal symptoms, such as bloating, upper abdominal discomfort or pain, and vomiting. These symptoms are related to the presence of reduced motor activities attributed to impaired gastric antral contractions and myoelectrical activity, and delayed gastric emptying, as well as slow small bowel transit (1,3,14,38). The abnormality of upper gastrointestinal motility may be related to fecal stasis in the rectum or colon, causing reflexive inhibition (5,11,20,54).…”

Electroacupuncture improves impaired gastric motility and slow waves induced by rectal distension in dogs

“…These patients frequently complain of upper abdominal symptoms such as bloating, upper abdominal discomfort or pain, and vomiting. The symptoms overlap with lower abdominal symptoms and are resistant to dietary and pharmacological treatments because of the constipation issues; they are related to the presence of impaired gastrointestinal myoelectrical activity and reduced upper gastrointestinal motor activity (1,4,13,31,33,37). This phenomenon has led to the hypothesis that rectal distension (RD) with fecal stasis in the colorectal region directly causes reflexive inhibition of proximal gastrointestinal motility (5,7,9,22,32,50).…”

Plasma Cholecystokinin, Plasma Peptide YY and Gallbladder Motility in Patients with Slow Transit Constipation: Effect of Intestinal Stimulation

“…Disorders of antroduodenal motility [1, 2], gastric retention of a meal [3, 4, 5], impaired gallbladder emptying [6]and a prolonged small bowel transit time [4]have been reported in these patients as well. The pathophysiological mechanisms that underlie these functional disturbances are poorly understood.…”