MOTILITY AND LOWER GUT SYMPTOMS

Abdominal symptoms due to motility disturbances of the lower gut consi st mainly of discrete pain episodes or a long-lasting feeling of fulln ess and distension. Long-term recording has shown that these symptoms are partly related to propagated contraction waves of the colon which induce mass movement of colonic contents. Patients probably experience that normal contractile activity is unpleasant or painful and apparen tly have a decreased threshold of perception. Also, peculiar contracti on patterns of the small intestine ('clustered contractions') have bee n related to pain episodes. Fullness and distension are characteristic for stow transit constipation, but also occur in disordered defecatio n. Future studies on treatment will have to concentrate on pathophysio logically defined subgroups.