Intact colonic motor response to sudden awakening from sleep in patients with chronic idiopathic (Slow-Transit) constipation

PURPOSE: There are few data about the relationships between colonic motor b ehavior and higher brain functions, such as sleep. Previous studies were do ne in healthy subjects, and it is unknown whether patients with functional motor disorders of the colon behave differently. This study was designed to characterize colonic motor activity in patients with constipation, both du ring sleep and after sudden awakening, and to compare it with that of healt hy subjects. Our working hypothesis was that patients with constipation wou ld have an impaired response to sudden awakening. PATIENTS AND METHODS: Twe lve chronically constipated women, 22 to 49 years old, were recruited for t he study, and their data were compared with those obtained from 12 healthy female volunteers, 21 to 38 years old. Manometric studies were performed in the descending and sigmoid colon for 30 minutes during sleep (immediately before awakening) and 30 minutes after being awakened suddenly. A motility index: was calculated before and after the stimulus. RESULTS: In both group s motility in the descending and the sigmoid colon was almost absent during sleep and significantly increased after sudden awakening. No difference in postawakening values was found between patients with constipation and cont rols. CONCLUSIONS: In patients with chronic constipation, the brain-gut con trol of some fundamental mechanisms governing colonic motility is preserved . These data suggest that the alterations of colonic motility described in chronic constipation may be caused by an intrinsic dysfunction of the viscu s.