The clinical evaluation of idiopathic constipation with relation to colon and anorectal physiology

The causes of chronic constipation are many. With no obvious causes; the condition is called 'idiopathic constipation'. The purpose of this study is to discover the possible causes of this type of constipation by analyzing colon motility, anorectal function and the defecating process. One hundred patients and 50 normal persons formed the study group and control group, respectively. Both groups underwent the same series of examinations including colon transit time, balloon expulsion test, anal sphincter-resting and squeeze-pressures, anorectal inhibitory reflex and a rectal sensation test. The study group had the defecography test also. The results from the control group set the norms. The results of the study group fell into the following four categories: 1. Abnormal colon transit with normal anorectal function and anatomy - 18%; 2. Normal colon transit with abnormal anorectal function - 32%; 3. Abnormal colon transit and anorectal function - 48%; 4. Anorectal anatomic deformity - 2%. It was concluded that have anorectal functional abnormality with or without colonic dysmotility was the major cause (80%) of idiopathic constipation. A series of examinations are necessary for these patients, and the appropriate treatment can be provided, according to those findings.