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Rectosigmoid Localization of Radiopaque Markers for Identifying Defecation Disorders in Patients With Chronic Constipation: A Retrospective Cohort Study

BACKGROUND/AIMS: Defecation disorders (DD) are part of the spectrum of chronic constipation with outlet obstruction. Although anorectal physiologic tests are required for the diagnosis of DD, these tests are not available in many institutions. This study aims to investigate the predictivity of DD us...

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Autores principales: Abe, Tatsuya, Kunimoto, Masao, Hachiro, Yoshikazu, Ohara, Kei, Inagaki, Mitsuhiro, Murakami, Masanori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Neurogastroenterology and Motility 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266493/
https://www.ncbi.nlm.nih.gov/pubmed/34210907
http://dx.doi.org/10.5056/jnm20204
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author Abe, Tatsuya
Kunimoto, Masao
Hachiro, Yoshikazu
Ohara, Kei
Inagaki, Mitsuhiro
Murakami, Masanori
author_facet Abe, Tatsuya
Kunimoto, Masao
Hachiro, Yoshikazu
Ohara, Kei
Inagaki, Mitsuhiro
Murakami, Masanori
author_sort Abe, Tatsuya
collection PubMed
description BACKGROUND/AIMS: Defecation disorders (DD) are part of the spectrum of chronic constipation with outlet obstruction. Although anorectal physiologic tests are required for the diagnosis of DD, these tests are not available in many institutions. This study aims to investigate the predictivity of DD using rectosigmoid localization of radiopaque markers in a colonic transit study. METHODS: A total of 169 patients with refractory constipation with a mean age of 67 years were studied. All patients underwent anorectal manometry, a balloon expulsion test, and a colonic transit study. Barium defecography was performed if needed. The relationship between DD diagnosed by these anorectal tests and the rectosigmoid accumulation of markers was examined. RESULTS: Seventy-nine (46.7%) patients were identified to have DD based on anorectal test combinations. Rectosigmoid accumulation of markers was observed in 39 (23.1%) patients. The sensitivity and positive predictive value of rectosigmoid accumulation for identifying DD were 31.6% and 64.1%, respectively. Rectosigmoid accumulation provided poor discrimination of DD from normal transit constipation, at a specificity of 82.1% but with a sensitivity of only 10.6%. In discriminating DD from slow transit constipation, rectosigmoid accumulation was found to be useful with a positive likelihood ratio of 5.3. CONCLUSIONS: Rectosigmoid accumulation of markers can differentiate DD from slow transit constipation. However, non-rectosigmoid accumulation does not exclude the presence of DD.
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spelling pubmed-82664932021-07-30 Rectosigmoid Localization of Radiopaque Markers for Identifying Defecation Disorders in Patients With Chronic Constipation: A Retrospective Cohort Study Abe, Tatsuya Kunimoto, Masao Hachiro, Yoshikazu Ohara, Kei Inagaki, Mitsuhiro Murakami, Masanori J Neurogastroenterol Motil Original Article BACKGROUND/AIMS: Defecation disorders (DD) are part of the spectrum of chronic constipation with outlet obstruction. Although anorectal physiologic tests are required for the diagnosis of DD, these tests are not available in many institutions. This study aims to investigate the predictivity of DD using rectosigmoid localization of radiopaque markers in a colonic transit study. METHODS: A total of 169 patients with refractory constipation with a mean age of 67 years were studied. All patients underwent anorectal manometry, a balloon expulsion test, and a colonic transit study. Barium defecography was performed if needed. The relationship between DD diagnosed by these anorectal tests and the rectosigmoid accumulation of markers was examined. RESULTS: Seventy-nine (46.7%) patients were identified to have DD based on anorectal test combinations. Rectosigmoid accumulation of markers was observed in 39 (23.1%) patients. The sensitivity and positive predictive value of rectosigmoid accumulation for identifying DD were 31.6% and 64.1%, respectively. Rectosigmoid accumulation provided poor discrimination of DD from normal transit constipation, at a specificity of 82.1% but with a sensitivity of only 10.6%. In discriminating DD from slow transit constipation, rectosigmoid accumulation was found to be useful with a positive likelihood ratio of 5.3. CONCLUSIONS: Rectosigmoid accumulation of markers can differentiate DD from slow transit constipation. However, non-rectosigmoid accumulation does not exclude the presence of DD. The Korean Society of Neurogastroenterology and Motility 2021-07-30 2021-07-30 /pmc/articles/PMC8266493/ /pubmed/34210907 http://dx.doi.org/10.5056/jnm20204 Text en © 2021 The Korean Society of Neurogastroenterology and Motility https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Abe, Tatsuya
Kunimoto, Masao
Hachiro, Yoshikazu
Ohara, Kei
Inagaki, Mitsuhiro
Murakami, Masanori
Rectosigmoid Localization of Radiopaque Markers for Identifying Defecation Disorders in Patients With Chronic Constipation: A Retrospective Cohort Study
title Rectosigmoid Localization of Radiopaque Markers for Identifying Defecation Disorders in Patients With Chronic Constipation: A Retrospective Cohort Study
title_full Rectosigmoid Localization of Radiopaque Markers for Identifying Defecation Disorders in Patients With Chronic Constipation: A Retrospective Cohort Study
title_fullStr Rectosigmoid Localization of Radiopaque Markers for Identifying Defecation Disorders in Patients With Chronic Constipation: A Retrospective Cohort Study
title_full_unstemmed Rectosigmoid Localization of Radiopaque Markers for Identifying Defecation Disorders in Patients With Chronic Constipation: A Retrospective Cohort Study
title_short Rectosigmoid Localization of Radiopaque Markers for Identifying Defecation Disorders in Patients With Chronic Constipation: A Retrospective Cohort Study
title_sort rectosigmoid localization of radiopaque markers for identifying defecation disorders in patients with chronic constipation: a retrospective cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266493/
https://www.ncbi.nlm.nih.gov/pubmed/34210907
http://dx.doi.org/10.5056/jnm20204
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