Consistency between symptoms and colorectoanal function tests in elderly patients with functional constipation

Abstract

Objective To analyze the consistency between constipated symptoms and the parameters of gastrointestinal transit time (GITT), anorectal manometry (ARM) in elderly patients with functional constipation. Methods Total 111 patients (54 males and 57 females) with an average age of (70.2±6.5) years, who met Rome Ⅲ criteria of functional constipation were enrolled from June 2010 to October 2012. After enrollment, patients took two-week diary, recording the spontaneous bowel movements per week, stool type of Bristol Stool Form, the frequency and severity of defecation straining, sensation of anorectal obstruction, manual maneuvers and sensation of incomplete evacuation. The GITT and ARM tests were performed, and the consistency between symptoms and test results were analyzed. Results Patients with symptoms of slow transit, defecation disorder and mixed symptoms were 19.8% (22/111), 16.2% (18/111) and 59.5% (66/111) respectively; and 4.5% (5/111) patients had scattered symptoms. Based on results of GITT, slow transit subtype, defecation disorder subtype and mixed subtype were 54.1% (59/109), 1.8% (2/109) and 29.4% (32/109) respectively; and 14.7% (16/109) patients were with normal transit time. ARM results showed that 38.0% (41/109) of patients had dyssynergic defecation. The percentage of slow transit in GITT test showed no significant difference between patients with slow transit symptoms and mixed symptoms[50.0% (11/22) vs. 57.9% (33/57) , χ2=0.401, P=0.527]. The consistency of predominant symptom with GITT subtype was low (к=-0.013). The percentage of dyssynergic defecation detected with ARM showed no significant difference between patients with defecation disorder-predominant symptom and with mixed symptom [23.1% (6/24) vs. 38.2% (21/55) , χ2=1.813, P=0.178]. The consistency of defecation disorder-predominant symptom with dyssynergic defecation in ARM was low (к=-0.019). Conclusion The mixed subtype symptoms are the most common presentations of elderly patients with functional constipation, and the consistency of predominant constipated symptoms with GITT, ARM test results is poor. Key words: Aged; Constipation; Gastrointestinal transit; Anorectal manometry