Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Gregersen, Hans, Chen, Ssu-Chi, Leung, Wing Wa, Wong, Cherry, Mak, Tony, Ng, Simon, Daming, Sun, Futaba, Kaori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2021
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
_version_ 1783688566912581632
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
work_keys_str_mv AT gregersenhans characterizationofpatientswithobstructeddefecationandslowtransitconstipationwithasimulatedstool
AT chenssuchi characterizationofpatientswithobstructeddefecationandslowtransitconstipationwithasimulatedstool
AT leungwingwa characterizationofpatientswithobstructeddefecationandslowtransitconstipationwithasimulatedstool
AT wongcherry characterizationofpatientswithobstructeddefecationandslowtransitconstipationwithasimulatedstool
AT maktony characterizationofpatientswithobstructeddefecationandslowtransitconstipationwithasimulatedstool
AT ngsimon characterizationofpatientswithobstructeddefecationandslowtransitconstipationwithasimulatedstool
AT damingsun characterizationofpatientswithobstructeddefecationandslowtransitconstipationwithasimulatedstool
AT futabakaori characterizationofpatientswithobstructeddefecationandslowtransitconstipationwithasimulatedstool