Colonic propulsive impairment in intractable XXXX .

@entity1 @entity73 @entity1142
HYPOTHESIS: Intractable @entity1142 , especially of the slow-transit subtype, may represent several pathophysiologic entities with a common final symptomatic appearance. An overall impairment of colonic propulsive activity may represent a major disease mechanism. DESIGN: Case series. SETTING: Tertiary university hospital. SUBJECTS: Twenty-nine severely @entity1142 @entity1 with clinical and homogeneous features of @entity73 that were unresponsive to conventional medical measures and 16 age-matched healthy volunteers. INTERVENTIONS: Twenty-four-hour manometric recordings obtained in @entity1 and controls to assess high- and low-amplitude colonic propulsive activity. RESULTS: Compared with controls, @entity1 showed heavily reduced high-amplitude propagated activity (average, <1 event per subject per day). No differences were found in low-amplitude propagated activity. CONCLUSIONS: @entity1 with severe @entity1142 that is refractory to medical treatment may display an important reduction of colonic forceful propulsive activity. This may justify a surgical approach, which may offer the best results in such @entity1 . It is, however, important to obtain thorough physiologic documentation before such a drastic approach is considered. The residual low-amplitude propulsive activity might represent a partially compensatory mechanism in these @entity1 . Studies in more homogeneous groups of such @entity1 are needed.
