Prolonged ambulatory recording of antroduodenal motility in slow-transit constipation

Background: Slow-transit constipation may be part of a pan-enteric motor di sorder. To test this hypothesis 24-h ambulatory antroduodenal manometry was performed and orocaecal transit time determined in patients with slow-tran sit constipation and in healthy controls. Methods: Antroduodenal motility was recorded with a five-channel solid-stat e catheter. Postprandial motility was recorded after consumption of two sta ndardized test meals and interdigestive motility was recorded nocturnally. Manometry tracings were analysed for quantitative and qualitative abnormali ties. Orocaecal transit time was determined by means of the lactulose hydro gen breath test. Results: Postprandial motility was no different between patients and contro ls. However, some minor changes of interdigestive motility were observed. T he proportion of phase II activity of the nocturnal cycles of the interdige stive migrating motor complex was increased in patients while phase I activ ity was decreased. The total number of observed phase III fronts was no dif ferent in patients and controls, although the number of phase III fronts wi th antral onset was decreased. Furthermore, the amplitude of phase III acti vity of duodenal onset was also decreased. Specific motor abnormalities suc h as retrograde propagation of phase III fronts were more frequent in patie nts. Orocaecal transit time was delayed in patients. Conclusion: In patients with slow-transit constipation, orocaecal transit t ime is delayed but antro- duodenal motility is generally well preserved wit h only minor alterations.