Motility Disorders of the Colon and Rectum

  • Uday C. Ghoshal
Part of the GI Surgery Annual book series (GISA, volume 22)


A large proportion of patients with constipation presenting in tertiary care practice have refractory constipation in whom the primary treatment such as lifestyle modification, osmotic laxative and fibre has failed. A considerable number of these patients may be suffering from colonic and anorectal motility disorders such as slow colonic transit, faecal evacuation disorder or a combination of these. In a study from a tertiary care centre in Thailand, of 103 patients with chronic constipation, 30, 14, 11 and 48 patients were diagnosed to have anorectal dysfunction, colonic inertia, anorectal dysfunction with colonic inertia, and normal transit constipation, respectively [1]. In a retrospective study from our centre, of 130 patients with chronic constipation referred for anorectal physiological testing, 46 % had abnormal anorectal manometry and 35 % abnormal balloon expulsion test, and 17 % of 48 patients undergoing defaecography had abnormal results suggesting faecal evacuation disorder (unpublished data). In another recent Indian study, of 99 patients with primary chronic constipation, 46, 15 and 40 had normal transit, slow transit constipation, and faecal evacuation disorder, respectively [2]. It is important to understand these pathophysiological mechanisms to treat these patients effectively. Faecal incontinence, another motility abnormality of the anorectum, is not reviewed here.


Botulinum Toxin Rectal Prolapse Chronic Constipation Anorectal Manometry Colonic Motility 
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.


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Copyright information

© T.K. Chattopadhyay 2015

Authors and Affiliations

  • Uday C. Ghoshal
    • 1
  1. 1.Department of GastroenterologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia

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