만성변비환자에서 대장통과 시간 측정의 유용성
Usefulness of Colonic Transit Time Measurement in Chronic Constipation
이건영, 심강섭, 김광호, 박응범,
소속 상세정보
이건영 ( Lee Gun-Young )
이화여자대학교 의과대학 외과학교실
심강섭 ( Sim Kang-Sub )
이화여자대학교 의과대학 외과학교실
김광호 ( Kim Kwang-Ho )
이화여자대학교 의과대학 외과학교실
박응범 ( Park Eung-Bum )
이화여자대학교 의과대학 외과학교실
KMID : 0356719980140030569
Abstract
A retrospective study of 274 patients who presented with constipation was done. The following results were obtained by recording colonic transit time. The male to female ratio was 72 : 197, and most patients were in their third and fifth decade, each age group accounting for 21% of total number. Associated symptoms were anal discomfort(33%), abdominal discomfort (25%), hematochezia (23%), reduced stool caliber (11%), and tenesmus (8%). As a result, 223 patients had normal transit time and 51 patients had abnormal transit time. Eighty-six patients with normal transit time and 51 patients with abnormal transit time underwent barium enema or colonoscopic examination. Abnormal lesions such as polyps and diverticulums were found in 10 patients with normal transit time and 7 patients with abnormal transit time. Therefore barium enema and colonoscopic examination in the patients with abnormal transit time were meaningful (P=0.024). Eighteen out of 25 patients with normal transit time and 8 (67%) of 12 patients with abnormal transit time showed abnormal defecogram results. The rectocele was the most frequent cause of abnormality in defecogram. Abnormal anal manometry results were obtained in 5 (22%) of 23 patients with normal transit time and 3 (50%) of 6 patients with abnormal transit time. Three types were classified in the patients with abnormal transit time. With type II patients, anal manometry findings were normal and 2 patients showed abnormal results in defecogram. With type III patients, 5 (43%) of 12 patients showed abnormal results in defecogram and 3 (50%) of 6 patients had abnormal anal manometry findings. Conclusively, if abnormal transit time is found in the patients with chronic consipation, further evaluations such as barium enema or colonoscopic examination are necessary. And even in the patients without any abnormality in transit time, selected performance of defecogram and anal manometry depending on clinical symptoms are preferable.
키워드
Constipation;Transit time
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