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Colonic response to food in constipation

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objectives

Colonic response to food is possibly abnormal in constipation.

Methods

The colonic response to food was evaluated in 323 patients and 60 healthy subjects by following the movements of radiopaque markers after ingestion of a standard 1,000-cal test meal. Constipated patients were divided into four groups: one with a normal, and three with a delayed colorectal transit time. When the delay was found mainly in the ascending colon, the group was labeled as suffering from “colonic inertia”. In “hindgut dysfunction”, the delay was predominantly found in the descending colon, whereas the term “outlet obstruction” was reserved for constipated patients whose major site of delay was the rectosigmoid area. Colonic response to food was quantified by evaluating the variation of markers in a given abdominal region and the evolution of the geometric center on the entire plain film of the abdomen.

Results

Emptying of the caecum-ascending colon and filling of the rectosigmoid area characterize the colonic response to food in healthy subjects. Constipated patients also filled the rectosigmoid, but different patterns were found in the colon. In constipated patients with transit in the normal range, there was a frequent (41%) absence of colonic response to food as compared to controls (13%) and constipated patients with delayed transit (p<0.0001). The response to food of patients with colonic inertia was similar to that of healthy subjects in terms of distal progression, but less marked. The hindgut dysfunction group emptied the entire left colon but failed to empty the caecum and ascending colon. In the outlet obstruction group, there was no distal progress of the geometric center after meal.

Conclusions

Abnormal colonic response to food is frequently found in constipated patients, with different patterns according to the type of constipation.

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Authors and Affiliations

  1. Laboratoire de Physiologie Digestive, Hôpital Broussais, Université Paris V, 96, rue Didot, 75014, Paris, France

    Michel Bouchoucha, Alain Faye & Michel Arsac

  2. Hôpital Avicenne, Bobigny, France

    Michel Bouchoucha & Philippe Le Toumelin

  3. Département de Chirurgie, Centre Hospitalier Universitaire de Sherbrooke (CHUS-F), J1H5N4, Sherbrooke, Québec, Canada

    Ghislain Devroede

  4. Service de Physiologie, CHU 14033, Caen, France

    Pierre Arhan

Authors
  1. Michel Bouchoucha
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  2. Ghislain Devroede
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  3. Alain Faye
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  4. Philippe Le Toumelin
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  5. Pierre Arhan
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  6. Michel Arsac
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Correspondence to Michel Bouchoucha.

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Bouchoucha, M., Devroede, G., Faye, A. et al. Colonic response to food in constipation. Int J Colorectal Dis 21, 826–833 (2006). https://doi.org/10.1007/s00384-005-0787-5

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  • DOI: https://doi.org/10.1007/s00384-005-0787-5

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