Clinical-alimentary tractPredictive value of the balloon expulsion test for excluding the diagnosis of pelvic floor dyssynergia in constipation☆
Section snippets
Patient population and selection criteria
Patients were recruited prospectively from the Digestive Motility Department of the Clinic University Hospital of Valencia between June 1994 and January 2002 and were examined to establish the diagnosis of FC according to the Rome I criteria (presence of 2 or more of the following for at least 12 weeks in the preceding 12 months and for at least one fourth of the time: 2 or fewer bowel movements per week, lumpy or hard stools, straining at defecation, or sensation of incomplete evacuation).6
Results
A total of 359 patients with suspicion of FC were referred to our department. Forty-three constipated patients did not satisfy the Rome I criteria. Sixty-four patients were excluded because of severe systemic/psychological disorders or medication use, which could influence constipation. Severe depression was detected in 18 patients, eating disorders in 8, other psychological disorders in 4, endocrine diseases in 17 (hypothyroidism in 11 and diabetes mellitus in 6), traumatic or neurologic
Discussion
The balloon expulsion test has been used to identify constipated patients with outlet dysfunction. The first study that compared its results between constipated patients and healthy volunteers showed an inability of most patients to expel the balloon, but subtypes of constipation were not differentiated.9 Another report established a pattern of pelvic floor outlet obstruction by defecography in 21 constipated patients, and 12 of the patients were unable to expel a water-filled balloon.3
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2021, Clinical Gastroenterology and Hepatology
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Supported in part by a grant from the Instituto de Salud Carlos III (C03/02).