Constipation with colonic inertia

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Abstract
Transit of radiopaque markers was delayed in the ascending colon of 51 females and 3 males treated for severe idiopathic constipation. Onset of symptoms was between age 10 and 20 in more than half of the patients. Eighteen percent had previously undergone unnecessary laparotomy for large bowel pseudoobstruction. Stool frequency ranged from 1 stool every three days to 1 every 2 months. Twenty-six percent suffered from fecal incontinence. In addition, 30% had orthostatic hypotension and 15% galactorrhea of idiopathic origin. Patients had a higher than normal anal pressure (PPPPP=0.001) and gastroesophageal gradient weaker (P=0.05). Closing pressure of the sphincter was lower (PP2O in 31% of patients but never did in controls, and average maximal pressure was greater (PP<0.01). This study provides evidence that patients who suffer from constipation with colonic inertia also have abnormal function in other hollow viscera. The high incidence of extraintestinal symptoms provides further suggestion of the existence of one or more underlying systemic diseases.