| Obstipation is a frequently occurring problem (5-15% of the population) resulting in considerable morbidity and medical consumption. About 20% of the patients with chronic obstipation has slow colon passage (slow transit obstipation, STO). Recently techniques have become available for measuring the function of the colon. In this project the action of the colon will be examined with regard to motility (24 hours ambulatory pressure measurements), the signal function (visceroperception) in the upper and lower part of the colon, and the local reflexes, which are important for the adaptation and (re)action to stimuli (double colon barostat measurements). The techniques to be used are complex, the introduction of catheters must be done under endoscopic guidance (coloscopy). The group has extensive experience with these techniques. Our hypothesis is that in patients with STO not the motor activity is disturbed rather than that there are changes in visceroperception and in the intestino-intestinal reflexes due to which the function is being disturbed. In addition the contribution of the autonomic nervous system will be investigated since these reflexes are transmitted via the autonomic nerve system. In addition to patients with STO and controls, patients with chronic obstipation resulting from other causes will be examined. Research into the action of the colon under physiological and pathological conditions will lead to new insights into the pathophysiology of slow transit obstipation and contribute to a better selection of patients for surgical therapy. |
