Effects of conventional treatment of chronic functional constipation on total and segmental colonic and orocecal transit times.
OBJECTIVE
To evaluate the effects of conventional treatment of chronic functional constipation on total and segmental colonic transit times and on orocecal transit time.


METHODS
A total of 34 consecutive patients with functional constipation attending a specialized outpatient clinic were included in the study. Total and segmental colonic transit times were assessed using radiopaque markers. Hydrogen breath test was used to evaluate lactulose and bean orocecal transit times. Treatment consisted of disimpaction, general and dietary fiber intake instruction, and mineral oil administration.


RESULTS
At admission, colonic dysmotility was found in 71.9% (23/32) of patients. All patients who complied with the treatment showed improvement of clinical symptoms after 6 weeks of treatment, when 82.6% (19/23) of those with dysmotility at admission returned to normal or reduced the severity of colonic transit patterns. Transit time decreased (medians) between admission and eighth week of treatment: lactulose orocecal transit (from 70 to 50 minutes, p = 0.002), bean orocecal transit (from 240 to 220 minutes, p = 0.002), and total colonic transit (from 69.5 to 37.0 hours, p = 0.001). The need for mineral oil therapy for constipation after a 12-month treatment was associated with persistence of total colonic transit higher than 62 hours at the eighth week of treatment (p = 0.014).


CONCLUSIONS
The conventional therapeutic approach yielded good results regardless of the presence or not of colonic dysmotility at inclusion in the study. Digestive tract motility abnormalities in functionally constipated children may be reversed, and may be secondary to constipation.
Soares
Ana Cristina Fontenele
AC
Disciplina de Gastroenterologia Pediátrica, Universidade Federal de São Paulo - Escola Paulista de Medicina, São Paulo, Brazil.
Tahan
Soraia
S
Morais
Mauro Batista de
MB
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003248:Constipation / Q000628:therapy*; D019841:Defecography / Q000379:methods; D004043:Dietary Fiber / Q000627:therapeutic use; D007887:Fabaceae / Q000378:metabolism; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects / Q000502:physiology; D005772:Gastrointestinal Transit / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007792:Lactulose / Q000378:metabolism; D008297:Male; D008899:Mineral Oil / Q000627:therapeutic use; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors
D004043:Dietary Fiber; D007792:Lactulose; D008899:Mineral Oil