Colorectal bradyarrhythmia syndrome as risk factor for constipation and colorectal cancer

Abstract

Purpose. To prove that colorectal bradyarrhythmia syndrome is a precursor and predictor of constipation and colorectal cancer.Materials and methods. Using the non-invasive method of chronoenterography – weekly monitoring of the circadian rhythm of the enteral evacuation function, 2869 people who consider themselves relatively healthy were examined. The test ‘Rhythms and Health’ was used to identify the frequency and acrophase of the rhythm of defecation, as well as to assess the level of quality of life. We compared the occurrence of morning acrophase of the bowel rhythm in individuals with a regular bowel rhythm (at least 7 times a week) and in individuals with irregular (delayed) bowel function (with a stool frequency of 1–2 to 5–6 times a week). Three stages of colorectal bradyarrhythmia syndrome severity were analyzed: mild, moderate, and severe. The main symptoms of colorectal bradyarrhythmia syndrome were identified. The risk of colorectal cancer in patients with constipation was analyzed according to known data.The results of the study. It is shown that the earliest stages of enteral evacuation function irregularity (mild – 5–6, and moderate – 3 times a week 4 times a week) occur almost 10 times more often than the severe stage (1–2 times a week) of colorectal bradyarrhythmia syndrome in the form of constipation. A regular dependence of the regularity of the defecation rhythm on the position of the acrophase of this rhythm in the daily cycle was established: the regular rhythm of defecation (7 times a week) is associated with the presence of morning acrophase of the stool rhythm, and colorectal bradyarrhythmia (1–6 times a week) is associated with the absence of morning acrophase of the defecation rhythm. A natural relationship between a decrease in the frequency of defecation and a decrease in the level of quality of life was revealed. It is proved that the rarer the frequency of stool, the higher the tendency to take laxatives.Conclusions. Colorectal bradyarrhythmia syndrome occurs in both young people aged about 20 years and adults, and is almost 10 times more common than constipation. Constipation is a proven risk factor for colorectal cancer, as it increases this risk by 2–4 times. A high level of quality of life is characteristic of individuals with a regular stool rhythm, and colorectal bradyarrhythmia syndrome is characterized by a decrease in the level of quality of life in accordance with the aggravation of the stage of this syndrome.