Abstract
Purpose
Constipation is among the most common gastrointestinal disorders, although, there is no generally accepted objective diagnostic criteria thereof. It has been proposed that colorectal dimensions assessed with Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) may support the diagnosis, but normative data are lacking. The aim of this study was to describe colorectal dimensions in a sample of the general population and to investigate whether the dimensions were under influence by age and gender.
Methods
The maximum diameters and cross-sectional areas of the ascending colon, descending colon and rectum were determined from 119 CT scans of trauma patients (age groups from 15 to 70 years, 84 men and 35 women). A regression model was applied to explore the impact of age and gender on colorectal dimensions.
Results
Overall, great variations were found for all colorectal diameters and cross-sectional areas (median diameter (5% percentiles; 95% percentiles): ascending 46 (26; 63) mm; descending 29 (16; 48) mm; rectum 39 (22; 67) mm. Women had larger rectal cross-sectional areas, reflecting more rectal content, compared to men (p = 0.003). Age did not affect colorectal diameters or cross-sectional areas (all p > 0.10).
Conclusion
Great variations of colorectal dimensions were found. Larger rectal cross-sectional areas in women could likely reflect the fact that women have increased prevalence of constipation. Future studies should take gender into consideration when evaluating colorectal dimensions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The data that support the findings of this study are available upon reasonable request.
References
Beevers DG (1991) Clinical medicine. Postgrad Med J 67(787):494–494. https://doi.org/10.1136/pgmj.67.787.494
Bendezú RA, Mego M, Monclus E et al (2017) Colonic content: effect of diet, meals, and defecation. Neurogastroenterol Motil. https://doi.org/10.1111/nmo.12930
Bouras EP, Tangalos EG (2018) Chronic constipation in the elderly. Gastroenterol Clin NA 38(3):463–480. https://doi.org/10.1016/j.gtc.2009.06.001
Costilla VC, Foxx-Orenstein AE (2014) Constipation in adults: diagnosis and management. Curr Treat Opt Gastroenterol 12(3):310–321. https://doi.org/10.1007/s11938-014-0025-8
Enck P, Leinert J, Smid M, Köhler T, Schwille-Kiuntke J (2016) Prevalence of constipation in the German population—a representative survey (GECCO). United Eur Gastroenterol J 4(3):429–437. https://doi.org/10.1177/2050640615603009
Inoh Y, Kanoshima K, Ohkuma K et al (2018) Assessment of colonic contents in patients with chronic constipation using MRI. J Clin Biochem Nutr 62(3):277–280. https://doi.org/10.3164/jcbn.17-104
Krogh K, Chiarioni G, Whitehead W (2017) Management of chronic constipation in adults. United Eur Gastroenterol J 5(4):465–472. https://doi.org/10.1177/2050640616663439
Major G, Murray K, Singh G et al (2018) Demonstration of differences in colonic volumes, transit, chyme consistency, and response to psyllium between healthy and constipated subjects using magnetic resonance imaging. Neurogastroenterol Motil 30(9):e13400. https://doi.org/10.1111/nmo.13400
Manabe N, Kamada T, Hata J, Haruma K (2018) New ultrasonographic evaluation of stool and/or gas distribution for treatment of chronic constipation. Int J Colorectal Dis 33(3):345–348. https://doi.org/10.1007/s00384-018-2964-3
McCrea GL, Miaskowski C, Stotts NA, Macera L, Varma MG (2009) A review of the literature on gender and age differences in the prevalence and characteristics of constipation in North America. J Pain Symptom Manage 37(4):737–745. https://doi.org/10.1016/j.jpainsymman.2008.04.016
McCrea GL, Miaskowski C, Stotts NA, Macera L, Varma MG (2008) Pathophysiology of constipation in the older adult. World J Gastroenterol 14(17):2631–2638. https://doi.org/10.3748/wjg.14.2631
Oh JE, Kim YW, Park SY, Kim JY (2013) Estrogen rather than progesterone cause constipation in both female and male mice. Korean J Physiol Pharmacol 17(5):423–426. https://doi.org/10.4196/kjpp.2013.17.5.423
Pare P, Ferrazzi S, Thompson WG, Irvine EJ, Rance L (2001) An epidemiological survey of constipation in Canada: definitions, rates, demographics, and predictors of health care seeking. Am J Gastroenterol 96(11):3130–3137. https://doi.org/10.1111/j.1572-0241.2001.05259.x
Peppas G, Alexiou VG, Mourtzoukou E, Falagas ME (2008) Epidemiology of constipation in Europe and Oceania: a systematic review. BMC Gastroenterol 8:1–7. https://doi.org/10.1186/1471-230X-8-5
Simren M, Palsson OS, Whitehead WE (2017) Update on rome IV criteria for colorectal disorders: implications for clinical practice. Curr Gastroenterol Rep 19(4):15. https://doi.org/10.1007/s11894-017-0554-0
Funding
No funding was received for conducting this study.
Author information
Authors and Affiliations
Contributions
EBM: manuscript writing/editing, data analysis. SA-S: manuscript writing/editing, data collection or management. SSO: data analysis, protocol/project development. AMD: protocol/project development. KK: protocol/project development. JBF: manuscript writing/editing, data collection or management, protocol/project development.
Corresponding author
Ethics declarations
Conflict of interest
Authors state no conflict of interest.
Ethical approval
We declare that there are no ethical issues.
Consent for publication
All authors consent to the publication of the manuscript.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Mark, E.B., Al-Saadi, S., Olesen, S.S. et al. Colorectal dimensions in the general population: impact of age and gender. Surg Radiol Anat 43, 1431–1435 (2021). https://doi.org/10.1007/s00276-021-02756-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-021-02756-z