Abstract | BACKGROUND: METHODS: We retrospectively reviewed medical records of a selected group of 144 outpatients with chronic constipation who were refractory to treatment. These patients had undergone intracolonic motility and compliance measurements with an infinitely compliant balloon linked to a barostat. Data abstracted included barostat balloon mean volumes with increases in pressure (4 mmHg steps from 0 to 44 mmHg) before and after i.v. neostigmine. Vital signs and oxygen saturation before and after neostigmine were recorded. KEY RESULTS: Of the 144 patients, 133 were female, mean age was 41.0 ± 15.4 years (SD), and duration of constipation was 12.9 ± 13.8 years. Among patients who had undergone colonic transit measurement by scintigraphy, the overall colonic transit at 24 h (geometric center, GC24 [n = 115]) was 1.5 ± 0.7 (normal >1.3), and at 48 h (GC48 [n = 75]) it was 2.3 ± 0.9 (normal >1.9). Neostigmine decreased colonic compliance at lower distension pressures (e.g., 12 and 20 mmHg [both p < 0.001]), but not at 40 mmHg. There were expected minor changes in vital signs in response to neostigmine in 144 patients; however, one patient developed unresponsiveness, significant bradycardia, hypotension, and muscular rigidity that responded to 400 mcg i.v. atropine. CONCLUSIONS & INFERENCES:
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Authors | M A Mouchli, M Camilleri, T Lee, G Parthasarathy, P Vijayvargiya, M Halland, A Acosta, A E Bharucha |
Journal | Neurogastroenterology and motility
(Neurogastroenterol Motil)
Vol. 28
Issue 6
Pg. 871-8
(06 2016)
ISSN: 1365-2982 [Electronic] England |
PMID | 26840188
(Publication Type: Evaluation Study, Journal Article)
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Copyright | © 2016 John Wiley & Sons Ltd. |
Chemical References |
- Cholinesterase Inhibitors
- Neostigmine
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Topics |
- Adult
- Bradycardia
(chemically induced)
- Cholinesterase Inhibitors
(adverse effects, pharmacology, therapeutic use)
- Chronic Disease
- Colon
(drug effects, physiology)
- Constipation
(diagnostic imaging, drug therapy, physiopathology)
- Female
- Gastrointestinal Motility
(drug effects, physiology)
- Humans
- Male
- Manometry
(methods)
- Middle Aged
- Neostigmine
(adverse effects, pharmacology, therapeutic use)
- Radionuclide Imaging
- Retrospective Studies
- Treatment Outcome
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