title: Functional constipation with impaired rectal sensation improved by electrical stimulation therapy: report of a case.
abstract: Patients with intractable constipation often complain of social, physical, and psychologic stress. Recently, biofeedback therapy has been widely used for the management of intractable constipation, particularly in cases of constipation associated with pelvic floor dyssynergia. However, some constipated patients often complain of absent or diminished sense of wanting to defecate. It is unclear whether impaired rectal sensation is a cause or outcome of constipation and what specific treatment is available for these patients. We treated a 25-year-old female patient who complained of intractable constipation for ten years. Colon transit time study and defecography showed nonspecific findings. Her anorectal manometric findings were within normal ranges with the exception of impaired rectal sensation. Rectal sensory threshold volumes for desire and urge to defecate and maximal tolerated volume were greatly increased. She was treated by electric stimulation therapy for the purpose of improving impaired rectal sensory function. After 14 sessions of electric stimulation therapy, her constipated symptoms improved dramatically. Furthermore, the desire and urge threshold volumes were remarkably decreased. We report this case of constipation with impaired rectal sensation possibly treated by electric stimulation therapy.
authors.affiliation: Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Hye-Sook
authors.initials: HS
authors.lastname: Chang
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: In Ja
authors.initials: IJ
authors.lastname: Yoon
authors.forename: Oh Ryoun
authors.initials: OR
authors.lastname: Kwon
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Weon-Seon
authors.initials: WS
authors.lastname: Hong
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Il
authors.initials: YI
authors.lastname: Min
authors.forename: Chang Sik
authors.initials: CS
authors.lastname: Yu
mesh_terms: D000328:Adult; D003248:Constipation / Q000150:complications / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D012002:Rectal Diseases / Q000150:complications / Q000628:therapy*; D012007:Rectum / Q000294:innervation; D020886:Somatosensory Disorders / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome