Pilot Study of Pathophysiology of Constipation Among Community Diabetics
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We aimed to compare gastrointestinal transit anddefecatory function in a random sample of people with orwithout diabetes mellitus in a US community who reportedconstipation or laxative use. In this pilot study we measured: gastric, small bowel, andcolonic transit by scintigraphy; vector manometry ofanal sphincters at rest and during squeeze; defecatorydynamics by balloon expulsion test; and scintigraphic measurement of anorectal angle at rest andduring defecation. Autonomic function tests wereperformed in diabetics. Diabetics with constipation hada higher prevalence of abnormal evacuation or prolonged colonic transit during the first 24 hr thancontrols (P = 0.07): three had prolonged 24-hr colonictransit, and three abnormal evacuation. Amongconstipated controls, only one had anismus. Overall,diabetics had slower colonic transit during the first 24hr than nondiabetics (P < 0.05). Community diabeticswho experience constipation or use laxatives have agreater prevalence of delayed 24-hr colonic transit or evacuatory dysfunction than communitycontrols.
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