The effects of tegaserod on anorectal motility and rectal sensation in elderly patients with functional constipation .

Objective To study the anorectal motility and rectal sensation in elderly patients with functional constipation and the effects of tegaserod on anorectal motility and rectal sensation. Methods Thirty elderly patients and 22 non-elderly patients with functional constipation (EFC, NEFC) , 28 elderly healthy subjects (EHS) , 20 non-elderly healthy subjects (NEHS) were enrolled in the study. The patients with functional constipation were given oral administration of tegaserod (6 mg, Bid). After two weeks tegaserod treatment, the anorectal motility and rectal sensation of the patients with functional constipation were detected by Medtronic PC-Polygraf HR (made by Sweden) . Results (1) The rectal lowest volume of sensory threshold, the maximal volume of tolerance, maximal compliance and the morbidity of anorectal synchronous contraction when excretive action was imitated were (200±61) ml, (280±69) ml, (40. 5±10. g) ml/kPa, 46. 7% in EFC, (140±52) ml, (250±58)ml, (38. 6±12. 3) ml/ kPa, 36.2% in NEFC . They were higher than those in EHS (95±31)ml、(205±78)ml、(32. 9±12. 9)ml/ kPa、14. 2% and those in NEHS(75±38)ml、(190±50)ml、(30. 8±15. 2)ml/ kPa, 0. 0%(P0. 01). (2) The pressure of anal sphincter and the maximal squeeze pressure in EHS were (4. 9±0. 8) kPa and (9. 3±1. 6) kPa . They were lower than those in HS (6.6±1.3) kPa and (13. 3±1. 9) kPa(P0. 01). (3)After tegaserod treatment, the rectal lowest volume of sensory threshold , the maximal volume of tolerance, maximal compliance and the morbidity of anorectal synchronous contraction when excretive action was imitated in NEFC. They were lower than those in EHS and NEHS before treatment ( P0. 01). Conclusions (1) Lower sensitivity, higher tolerance and compliance of rectum and the disturbances of anorectal coordinating contraction may be associated with elderly functional constipation. (2)There are lower sensitivity of rectum and weaken anal automatic control function in elderly healthy subjects. (3) Tagasterod may improve the rectal sensation and the function of anorectal coordinating contraction in the patients with functional constipation.