Upper gastrointestinal motility in patients with slow-transit constipation

Background: Slow transit constipation is one of the common causes of chronic constipation. The number of Cajal cells in the muscular layer was decreased in the patients with slow colonic transit. Patients may have motor abnormalities not limited to the colon. The aim of this study was to determine motility abnormalities of the upper gastrointestinal tract in patients with slow-transit constipation.

Patients and Methods: 16 consecutive patients (5 male and 11 females, median age: 56 years, range: 46–70 years) and 10 healthy controls (7 male, 3 females, median age: 23 years, range: 20–24 years) were included in the study. Slow colon transit constipation was detected by colon transit markers. Colon transit is defined to be slow when the average time of colon transit is more then 72 hours. Gastric emptying was measured by C13 octanoid acid test, orocoecal transit time was measured by lactulose-H2 breath test. We determined T1/2, gastric emptying coefficient (GEC) and orocoecal tranzit time in patients and healthy control groups.

Results: Gastric emptying was slow in 62.5% of the patients. 2 patients had very slow gastric emptying. T1/2 time was significantly slow in the constipated group (110min vs. 68min, p<0.05), significant difference were observed in GEC between the patients and control group (4.0 vs. 2.7, p<0.05). Orocoecal transit time of patients with slow colonic transit was found to be more slow than that of healthy control, but it was not significant. (120min vs. 90min, NS).

Conclusion: Patients with slow colon transit constipation frequently display motor abnormalities of the upper gut. These findings further strengthen the concept that this condition may represent a panenteric disorder.