만성 변비증 환자에 대한 연구 - 병태생리학적 접근

Background/Aims: Constipation or defecatory difficulty is a symptom with multifactorial etiolo- gies, and understanding of the underlying physiologic abnormalities has facilitated successful treatment for patients with constipation. This study was carried out to evaluaie the underlying pathophysiologie. Of colorectal motor functions in patients with chronic constipation or defecatory difficulty. Methods: Between January 1993 and December 1993, 80 patients(M:]S, F:65, mean age 47 years, ranged IS--80) with constipation and/or defecatory difficulty(negative colonoscopy, barium enema, and biochemica1 tests), were evaluated hy questionnaire, office examination, colon transit studies, anorectal manometry, balloon expulsion studies, electromyography of the pelvic floor and defecography. Results: Based on these studies, patients were categorized as follows: slow transit constipation, 4 patients; pelvic tloor disorders, 50 patients; combined slow transit and pelvic flcx>r disorders, 17 patients, and idiopathic constipation, 9 patients. Among 67 patients with pelvic floor disorders, 30 patients were observed to have rectocele; 24 patients, rectal intussusception; 24 patients, descending perineal syndrome; 14 patients, anismus; 14 patients, abnormal rectal .ensation; 8 patients, rectal prolapse. Conclusions: The majority(over 80%) of Korean chronic constipated patients is shown to have pelvic fl