Advertisement

Severe, Idiopathic Constipation is Caused by a Distinct Abnormality of the Colonic Myenteric Plexus (Abstract)

  • S. Krishnamurthy
  • M. D. Schuffler
  • C. E. Pope
  • C. A. Rohrmann

Abstract

We analyzed 26 patients, all women with severe constipation without obvious organic cause. Clinical: 24/26 were between 19–39 yrs. The duration of constipation was from 1/2–30 yrs. 7 had constipation from childhood and 7 from adolescence. Stool frequency was once every 5–30 days; 16/26 had stools once in 10–30 days. 25/26 had abdominal pain, bloating and distention; 22/26 had nausea and 4/26 occasional vomiting. 4 patients previously had anorexia nervosa and 3 had psychiatric problems. All 26 were on multiple laxatives. Radiography: One patient had gaseous distension of the stomach; but no patient had gaseous distention of small bowel or colon; 13/13 had normal UGI and small bowel series. Barium enemas were normal in 16/26; 10/26 had long redundant colons and 6/10 had increased colonic widths (8–15 cm). None had a narrowed rectal segment. Esophageal manometry: 12/22 were normal. 10/22 had high amplitude (180–240 mm) peristalsis, 3/22 had long duration waves. Solid meal gastric emptying studies were normal in 23/23. Pathology: Mucosal rectal biopsies showed normal submucosal neurons in 26/26 and melanosis coli in 6/26. 12 had subtotal colectomies because of severe constipation. H&E stains of the resected colons showed normal circular and longitudinal muscles in 11/12, and thin muscle layers in 1/12. By this technique we saw no definite abnormalities of the myenteric plexus (MP); quantitative neuron counts were normal in 12/12.

Keywords

Anorexia Nervosa Myenteric Plexus Subtotal Colectomy Severe Constipation Idiopathic Constipation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Copyright information

© MTP Press Limited 1984

Authors and Affiliations

  • S. Krishnamurthy
  • M. D. Schuffler
  • C. E. Pope
  • C. A. Rohrmann

There are no affiliations available

Personalised recommendations