RESUMO
Background: Studies in patients with chronic severe constipation, suggest the presence of a diffuse motor disorder of the gastrointestinal tract. Aim: To investigate small bowel motor activity in a group of patients with severe constipation. Material and Methods: Forty three patients (age range 13 to 70 years, 40 women) with severe constipation referred to our motility laboratory, where studied. Ten had a previous colectomy. Radiological examinations showed a megacolon in 30 and dilatation of small intestinal loops in nine; the remaining X rays studies were normal. Small intestinal motility was studied using perfused catheters and external transducers. Results: Ten patients had normal motor recordings. Eight patients showed a neuropathic disorder characterized by a continuous irregular pattern of contractions of normal amplitude, with absence of phase III of the migrating motor complex (MMC). Sixteen presented a normal MMC associated to a decreased amplitude of contractions (Miopatic disorder). Nine showed both types of motor disorders (Mixed pattern). Normal radiological findings were more commonly associated to normal manometric recordings. By contrast, an altered motor activity, mainly of myopathic and mixed type motor disorder, was observed in all patients with dilated small intestinal and colonic loops. Conclusions: The presence of small intestinal motor disorders was a frequent finding in this selected group of patients with chronic constipation.