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RISS 인기검색어
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- 저자 : 강성웅(Seoung Woong Kang) (검색결과 2 건)
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박효진(Hyo Jin Park),이찬희(Chan Hee Lee),정준표(Jun Pyo Chung),이관식(Kwan Sik Lee),이상인(Sang In Lee),박인서(In Suh Park),손승국(Seung Kook Sohn),지훈(Hoon Ji),강성웅(Seoung Woong Kang) 대한내과학회 1994 대한내과학회지 Vol.46 No.5
N/A Objectives: As nonorganic, or functional factors play an important etiopathogenetic role in chronic constipation, we have reviewed functional tests on patients with chronic idiopathic constipation. Results of investigation and subsequent proper treatment are suggested. Methods: Clinical assessment, colonic transit, defecogram, anorectal manometry and pelvic floor electrophysiologic tests were performed in 30 patients with chronic idiopathic constipation, Results: 1) The ratio of male to female was 1:4, and the mean age was 48.2 years. Primary complaints were incomplete evacuation (83.3%), abdominal fullness (70.0%), abdominal pain (70.0%), rectal bleeding (43.3%), nausea (33.3%), tenesmus (33.3%) and dysuria (20.0%). Hemorrhoids and melanosis coli were present in 70.4% and 11.1% of the patients respectively at colonoscopy. The types of personality using the Minnesota Multiphasic Personality Inventory showed somatization 50.0% and psycho- physiological reaction 41.7%. 2) Colonic transit studies identified three patterns: normal transit 38.9%, colonic inertia 22.2%, pelvic outlet obstruction 16.7%, and mixed type 22.2%. The mean transit time of total colon was 56.4±5.0 hr. in colonic inertia and mixed type. 3) Defecogram revealed rectocele 77.8%, incomplete evacuation 48.1%, paradoxical contraction of puborectalis 40.7%, rectal intussusception 25.9%, parietal rectal rigidity 11.1%, and excessive pelvic floor descent 11.1%. 4) The mean minimal sensory volume, anal sphincter length, maximum resting and squeeze anal pressure was 47.9±17.5 ml, 3.9±0.9 cm, 104.3±17.9mmHg and 156.4±15.0mmHg respectively. The anorectal inhibitory reflex was intact in all patients. 5) Electrophysiologic studies suggested pudendal neuropathy in 5 patients (27.8%). 6) The patients were treated by drug therapy 83.3%, biofeedback therapy 10.0% and operation 6.7%. Conclusion: From the above results, systematic diagnostic evaluation and proper treatment for the patients with chronic idiopathic constipation in view of functional motility disorder are required and treatment can be helpful particularly when directed by a multidisciplinary team approach.
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