Medical expert of the article
New publications
Diagnosis of colonic dyskinesias
Last reviewed: 04.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Diagnosis of colon dyskinesia is based on a thorough collection of anamnesis and the results of instrumental diagnostic methods.
Colonodynamic and electromyographic studies allow us to measure the parameters of the reservoir and evacuation functions of the colon and assess the condition of the anal sphincters:
- with hypertonic dyskinesia, a decrease in the volume of the distal intestine and an accelerated appearance of the reflex to emptying are noted;
- In hypotonic dyskinesia, the volume of the distal section is increased, hyporeflexia is pronounced, often in combination with rectodolichosigma.
Rectomanoscopy and sigmoidoscopy allow us to assess the condition of the mucous membrane and the tone of the distal parts of the colon:
- in hypertonic dyskinesia and "irritable bowel syndrome" the intestinal lumen is narrowed, haustration is pronounced, minor hyperemia and injection of the mucous membranes can be detected, histological signs of inflammatory or dystrophic changes are not detected;
- With hypotonic dyskinesia, the colon is collapsed, or its lumen may be widened, and the circular folds are shortened.
Irrigography allows to assess the tone and emptying of the colon, to exclude puborectal loop insufficiency, congenital defects (dolichosigma, Hirschsprung's disease):
- In hypertonic dyskinesia, the intestinal lumen is narrowed, haustration is increased, and emptying is not impaired.
- With hypotonic dyskinesia, the distal parts of the intestine are dilated and emptying is slow.
Differential diagnosis of colon dyskinesia is carried out with chronic colitis and congenital diseases - dolichosigma and Hirschsprung's disease.
Dolichosigma -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, stool is independent, but later, to empty the intestines, it is necessary to resort to taking laxatives or cleansing enemas. The diagnosis is established on the basis of irrigography data.
Hirschsprung's disease is a congenital aganglionosis of a section of the colon, which can be localized at different levels - the higher the level of aganglionosis, the earlier constipation appears and the more severe the disease. Constipation bothers from the first year of life, progressively increasing. X-rays reveal expansion of the colon sections located above the aganglion zone, which has the appearance of a narrowed section. In doubtful cases, a study is carried out in a biopsy of the mucous membrane of the narrowed section of the colon of acetylcholinesterase activity, which is increased in Hirschsprung's disease. Treatment of Hirschsprung's disease is surgical.
[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ], [ 10 ]