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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Colorectal motility patterns and psychiatric traits in functional constipation and constipation-predominant irritable bowel syndrome: A study from China
Chao-Lan Lv, Geng-Qing Song, Jie Liu, Wei Wang, Yi-Zhou Huang, Bo Wang, Jia-Shuang Tian, Meng-Qing Yin, Yue Yu
Chao-Lan Lv, Jie Liu, Yue Yu, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, Anhui Province, China
Chao-Lan Lv, Jie Liu, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
Geng-Qing Song, Department of Gastroenterology and Hepatology, Metrohealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, United States
Wei Wang, Jia-Shuang Tian, Meng-Qing Yin, Department of Gastroenterology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, Anhui Province, China
Yi-Zhou Huang, Bo Wang, Department of Gastroenterology, Graduate School of Bengbu Medical College, Bengbu 233000, Anhui Province, China
Author contributions: Yu Y designed the study and critically revised the article for important intellectual content; Lv CL participated in the analysis and interpretation of the data, and drafted the initial manuscript; Song GQ participated in project supervision and editing the manuscript; Liu J, Wang W, Huang YZ, Wang B, Tian JS, and Yin MQ participated in acquisition of the data.
Supported by the External Science and Technology Cooperation Planning Projects of Anhui Province of China, No. 1604b060202.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Anhui Provincial Hospital.
Informed consent statement: As approved by the Ethics Board, informed consent was not required for this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Yue Yu, MD, PhD, Professor, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China, No. 9 Lujiang Road, Hefei 230001, Anhui Province, China. yuyuemd@ustc.edu.cn
Received: July 10, 2023
Peer-review started: July 10, 2023
First decision: September 1, 2023
Revised: September 14, 2023
Accepted: October 11, 2023
Article in press: October 11, 2023
Published online: November 7, 2023
ARTICLE HIGHLIGHTS
Research background
The comparation of colorectal motility, psychiatric features, and the association of colorectal motility patterns and psychiatric traits between functional constipation (FC) and constipation-predominant irritable bowel syndrome (IBS-C) groups, especially in the Chinese population has not been fully studied.
Research motivation
Controversy persists regarding the correlation between high-resolution anorectal manometry (HR-ARM) and the colonic transmit test (CTT), and it remains unclear which test provides more meaningful data for IBS-C or FC.
Research objectives
We aimed to compare the psychiatric and colorectal motility characteristics between FC and IBS-C patients in an Eastern Chinese population. We also sought to investigate the correlations between psychiatric and colorectal motility characteristics in both FC and IBS-C patients.
Research methods
Colorectal motility patterns were obtained by HR-ARM and CTT. Anxiety and depression were assessed by the Hamilton anxiety rating scale (HAMA) and the Hamilton Depression Rating Scale (HAMD)-21.
Research results
Our study indicated a higher prevalence of rectosigmoid accumulation of radiopaque markers (RSARM) and elevated anal resting pressure in FC patients compared to IBS-C patients. Furthermore, we observed that nearly half of the FC patients with RSARM exhibited type IV dyssynergia, a prevalence nearly double that of IBS-C patients. Our data also showed that IBS-C patients with normal transit time were more likely to experience anxiety compared to those with slow transit time. However, we found no significant correlations between psychological stress and colonic motility in FC patients. FC patients with type IV dyssynergia and IBS-C patients with type III dyssynergia are more likely to have dyssynergic defecation. Type I or II dyssynergia cannot rule out the need for CTT in chronic constipation patients, while it might not be necessary for FC patients with type IV dyssynergia and IBS-C patients with type III dyssynergia to undergo CTT, but further balloon expulsion test or defecography might still be necessary.
Research conclusions
The associations of psychological stress and colonic motility in our study are discrepant from results of Western studies, indicating that emotional factors may have varying effects on colonic motility between these two patient groups. The associations we found between CTT results and dyssynergia patterns by ARM could provide guidance for different constipation groups to choose appropriate colorectal tests.
Research perspectives
We compared not only colorectal motility and psychiatric features, but also the correlations between psychiatric and colorectal motility characteristics in FC and IBS-C patients. What we found could provide guidance for constipation patients to choose appropriate colorectal tests.
