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Characterization of Patients With Obstructed Defecation and Slow Transit Constipation With a Simulated Stool
INTRODUCTION: Defecatory disorders including obstructed defecation (OD) are currently diagnosed using specialized investigations including anorectal manometry and the balloon expulsion test. Recently, we developed a simulated stool named Fecobionics that provides a novel type of pressure measurement...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099406/ https://www.ncbi.nlm.nih.gov/pubmed/33949343 http://dx.doi.org/10.14309/ctg.0000000000000354 |
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author | Gregersen, Hans Chen, Ssu-Chi Leung, Wing Wa Wong, Cherry Mak, Tony Ng, Simon Daming, Sun Futaba, Kaori |
author_facet | Gregersen, Hans Chen, Ssu-Chi Leung, Wing Wa Wong, Cherry Mak, Tony Ng, Simon Daming, Sun Futaba, Kaori |
author_sort | Gregersen, Hans |
collection | PubMed |
description | INTRODUCTION: Defecatory disorders including obstructed defecation (OD) are currently diagnosed using specialized investigations including anorectal manometry and the balloon expulsion test. Recently, we developed a simulated stool named Fecobionics that provides a novel type of pressure measurements and analysis. The aim was to study OD phenotypes compared with slow transit constipation (STC) patients and normal subjects (NS). METHODS: Fecobionics expulsion parameters were assessed in an interventional study design. The Fecobionics device contained pressure sensors at the front, rear, and inside a bag. All constipation patients had colon transit study, defecography, anorectal manometry, and balloon expulsion test performed. The Fecobionics bag was distended in the rectum until desire-to-defecate in 26 OD compared with 8 STC patients and 10 NS. Rear-front pressures (preload-afterload parameters) and defecation indices (DIs) were compared between groups. RESULTS: The Wexner constipation scoring system score was 13.8 ± 0.9 and 14.6 ± 1.5 in the OD and STC patients (P > 0.5). The median desire-to-defecate volume was 80 (quartiles 56–80), 60 (54–80), and 45 (23–60) mL in OD, STC, and NS, respectively (P < 0.01). The median expulsion duration was 37 (quartiles 15–120), 6 (3–11), and 11 (8–11) seconds for the 3 groups (P < 0.03). Fecobionics rear-front pressure diagrams demonstrated clockwise loops with distinct phenotype differences between OD and the other groups. Most DIs differed between OD and the other groups, especially those based on the anal afterload reflecting the nature of OD constipation. Several OD subtypes were identified. DISCUSSION: Fecobionics obtained novel pressure phenotypes in OD patients. DIs showed pronounced differences between groups. Larger studies are needed on OD subtyping. |
format | Online Article Text |
id | pubmed-8099406 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer |
record_format | MEDLINE/PubMed |
spelling | pubmed-80994062021-05-06 Characterization of Patients With Obstructed Defecation and Slow Transit Constipation With a Simulated Stool Gregersen, Hans Chen, Ssu-Chi Leung, Wing Wa Wong, Cherry Mak, Tony Ng, Simon Daming, Sun Futaba, Kaori Clin Transl Gastroenterol Article INTRODUCTION: Defecatory disorders including obstructed defecation (OD) are currently diagnosed using specialized investigations including anorectal manometry and the balloon expulsion test. Recently, we developed a simulated stool named Fecobionics that provides a novel type of pressure measurements and analysis. The aim was to study OD phenotypes compared with slow transit constipation (STC) patients and normal subjects (NS). METHODS: Fecobionics expulsion parameters were assessed in an interventional study design. The Fecobionics device contained pressure sensors at the front, rear, and inside a bag. All constipation patients had colon transit study, defecography, anorectal manometry, and balloon expulsion test performed. The Fecobionics bag was distended in the rectum until desire-to-defecate in 26 OD compared with 8 STC patients and 10 NS. Rear-front pressures (preload-afterload parameters) and defecation indices (DIs) were compared between groups. RESULTS: The Wexner constipation scoring system score was 13.8 ± 0.9 and 14.6 ± 1.5 in the OD and STC patients (P > 0.5). The median desire-to-defecate volume was 80 (quartiles 56–80), 60 (54–80), and 45 (23–60) mL in OD, STC, and NS, respectively (P < 0.01). The median expulsion duration was 37 (quartiles 15–120), 6 (3–11), and 11 (8–11) seconds for the 3 groups (P < 0.03). Fecobionics rear-front pressure diagrams demonstrated clockwise loops with distinct phenotype differences between OD and the other groups. Most DIs differed between OD and the other groups, especially those based on the anal afterload reflecting the nature of OD constipation. Several OD subtypes were identified. DISCUSSION: Fecobionics obtained novel pressure phenotypes in OD patients. DIs showed pronounced differences between groups. Larger studies are needed on OD subtyping. Wolters Kluwer 2021-05-05 /pmc/articles/PMC8099406/ /pubmed/33949343 http://dx.doi.org/10.14309/ctg.0000000000000354 Text en © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Article Gregersen, Hans Chen, Ssu-Chi Leung, Wing Wa Wong, Cherry Mak, Tony Ng, Simon Daming, Sun Futaba, Kaori Characterization of Patients With Obstructed Defecation and Slow Transit Constipation With a Simulated Stool |
title | Characterization of Patients With Obstructed Defecation and Slow Transit Constipation With a Simulated Stool |
title_full | Characterization of Patients With Obstructed Defecation and Slow Transit Constipation With a Simulated Stool |
title_fullStr | Characterization of Patients With Obstructed Defecation and Slow Transit Constipation With a Simulated Stool |
title_full_unstemmed | Characterization of Patients With Obstructed Defecation and Slow Transit Constipation With a Simulated Stool |
title_short | Characterization of Patients With Obstructed Defecation and Slow Transit Constipation With a Simulated Stool |
title_sort | characterization of patients with obstructed defecation and slow transit constipation with a simulated stool |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099406/ https://www.ncbi.nlm.nih.gov/pubmed/33949343 http://dx.doi.org/10.14309/ctg.0000000000000354 |
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