Diagnostic testing in patients with chronic constipation

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Rao SS, Sadeghi P, Beaty J, Kavlock R: Ambulatory 24-hour colonic manometry in slow-transit constipation. Am J Gastroenterol 2004, 99:2405–2416.

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Rao SSC, Ozturk R, Laine L. Clinical utility of diagnostic tests for constipation in adults: A systematic review. Am J Gastroenterol 2005, 100:1605–1615. This systematic review assessed the clinical utility of diagnostic tests in adult patients with CC. Based on this review evidence to support the use of blood tests, radiography, or endoscopy in the routine workup of patients with constipation without alarm features is lacking. Colonic transit, anorectal manometry, and balloon expulsion tests reveal physiologic abnormalities in many patients with refractory constipation.

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Liu BH, Fang SW, Tong WD, Gong SG, Zhang SB. Role of pelvicography and colpocystodefecography in diagnosis of outlet obstructive constipation. Int J Colorectal Dis 2005, 20:317–320.

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Keshtgar AS, Ward HC, Glayden GS, Saneia A: Thickening of the internal anal sphincter in idiopathic constipation in children. Pediatr Surg Int 2004, 20:817–823.

Barthet M, Portier F, Heyries L, et al.: Dynamic anal endosonography may challenge defecography for assessing dynamic anorectal disorders: results of a prospective pilot study. Endoscopy 2000, 32:300–305.

Beer-Gabel M, Teshler M, Schechtman E, Zbar AP.: Dynamic transperineal ultrasound vs. defecography in patients with evacuatory difficulty: a pilot study. Int J Colorectal Dis 2004, 19:60–67.

Singh SJ, Gibbons NJ, Vincent MV, et al.: Use of pelvic ultrasound in the diagnosis of the megarectum in children with constipation. J Pediatr Surg 2005, 40:1941–1944.

Roos JE, Weishaupt D, Wildermuth S, et al.: Experience of 4 years with open MR defecography: pictorial review of anorectal anatomy and disease. Radiographics 2002, 22:817–832.

Fletcher JG, Busse RF, Riederer SJ, et al.: Magnetic resonance imaging of anatomic and dynamic defects of the pelvic floor in defecatory disorders. Am J Gastroenterol 2003, 98:399–411.

Dvorkin LS, Hetzer F, Scott SM, et al.: Open-magnet MR defaecography compared with evacuation proctography in the diagnosis and management of patients with rectal intussusception. Colorectal Dis 2004, 6:45–53.

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Qureshi W, Adler DG, Davila RE, et al.: ASGE guideline: guideline on the use of endoscopy in the management of constipation. Gastrointest Endosc 2005, 62:199–201. Guidelines from the American Society of Gastrointestinal Endoscopy(ASGE) on endoscopy in patients with CC. Colonoscopy is only recommended if patients have rectal bleeding, heme-positive stool, iron-deficiency anemia, weight loss, obstructive symptoms, and/or recent onset of symptoms.

Pepin C, Ladabaum U: The yield of lower endoscopy in patients with constipation: survey of a university hospital, a public county hospital and a veterans administration medical center. Gastrointest Endosc 2002, 56:325–332.

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Lundind E, Karlbom U, Westlin JE, et al.: Scintigraphic assessment of slow transit constipation with special reference to right- or left-sided colonic delay. Colorectal Dis 2004, 6:499–505.

Rao SS, Sadeghi P, Beaty J, Kavlock R: Ambulatory 24-hour colonic manometry in slow-transit constipation. Am J Gastroenterol 2004, 99:2405–2416.

Rao SS, Hatfield R, Soffer E, et al.: Manometric tests of anorectal function in healthy adults. Am J Gastroenterol 1999, 94:773–783.

Rao SSC, Patel RS: How useful are manometric tests of anorectal function in the management of defecation disorders. Am J Gastroenterol 1997, 92:469–475.

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Pelsang RE, Rao SSC, Welcher K. FECOM: A new artificial stool for assessing defecation. Am J Gastroenterol 1999, 94:183–186.

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Bassoti G, de Roberto G, Castellani D, et al.: Normal aspects of colorectal motility and abnormalities in slow transit constipation. World J Gastroenterol 2005, 11:2691–2696.

Gertken JT, Cocjin J, Pehlivanov N, et al.: Comorbidities associated with constipation in children referred for colon manometry may mask functional diagnoses. J Pediatr Gastroenterol Nutr 2005, 41:328–331.

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