Slow-Transit Constipation Is Linked to Abnormal Colonic Activity

Because the pathophysiologic basis of constipation remains unclear, the role of colonic dysfunction continues to be debated, and objective data, especially on colonic propulsive activity, are limited. As published in a recent issue of Digestion, Gabrio Bassotti, MD, PhD, and colleagues used 24-hour colonic manometric recordings to compare high- and low-amplitude colonic propulsive activity in constipated patients. The study compared colonic propulsive activity in 35 patients who had slow-transit constipation (STC) and 10 patients who had irritable bowel syndrome with constipation (IBS-C) with that in nonconstipated controls.

The investigators found that high-amplitude propagated contractions are significantly decreased in patients with STC and in patients with IBS-C, compared with those in controls. A significant decrease in contraction amplitude was also observed in patients with STC. With regard to low-amplitude propagated contractions, patients with STC had significantly fewer events, compared with patients with IBS-C.

The authors concluded that low-amplitude propagated contractions represent an important physiologic motor event in constipated patients. These contractions may preserve residual colonic propulsive activity in patients with STC.