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Diagnosis of dyskinesia of the colon
Last reviewed: 23.04.2024
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Diagnosis of dyskinesia of the colon is based on careful collection of history and the results of instrumental diagnostic methods.
Colonodynamic and electromyographic studies make it possible to measure the parameters of the reservoir and evacuation functions of the colon, assess the condition of anal sphincters:
- in hypertensive dyskinesia, decrease in the volume of the distal part of the intestine, accelerated appearance of the reflex to emptying;
- with hypotonic dyskinesia, the volume of the distal part is enlarged, hyporeflexia is expressed, often in combination with the rectodolyshosigma.
Recto-manoscopy, sigmoscopy allow to assess the condition of the mucosa and tone of the distal colon:
- with hypertensive dyskinesia and "irritable bowel syndrome" the lumen of the intestine is narrowed, gaustracis is expressed, it is possible to detect insignificant hyperemia and injection of mucous membranes, histological signs of inflammatory or dystrophic changes do not reveal;
- with hypotonic dyskinesia, the large intestine is asleep, or its lumen can be enlarged, the circular folds are shortened.
Irrigography allows you to assess the tone and emptying of the colon, exclude the failure of the puborectal loop, congenital malformations (dolichosigmus, Hirschsprung's disease):
- with hypertensive dyskinesia, the lumen of the intestine is narrowed, the gaustration is strengthened, the emptying is not disturbed.
- at hypotonic dyskinesia distal parts of the intestine are dilated, evacuation is slowed down.
Differential diagnosis of colon dyskinesia is carried out with chronic colitis and congenital diseases - dolichosigma and Hirschsprung disease.
Dolihosigma is an additional loop of the elongated sigmoid colon. Clinically, the disease manifests itself as persistent constipation, which appears from an early age, but not from birth. During the first years of life, the stool is independent, but later for the emptying of the intestine it is necessary to resort to laxative or cleansing enemas. The diagnosis is based on the data of the irrigography.
Hirschsprung's disease is a congenital aganglion of the part of the large intestine that can be localized at different levels - the higher the level of aganglion, the earlier there are constipation and heavier the disease. Constipation worries from the first year of life, progressively increasing. X-ray reveals the expansion of the colon sections located above the agangliosis zone, which looks like a narrowed section. In doubtful cases, a study is carried out in the biopsy specimen of the mucous membrane of the narrowed part of the colon of acetylcholinesterase activity, which is increased in Hirschsprung disease. Treatment of Hirschsprung's disease operative.
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