Preview

Russian Journal of Gastroenterology, Hepatology, Coloproctology

Advanced search

Constipation at endocrine diseases

Abstract

The aim of review. To demonstrate main causes of constipation at various endocrine diseases, to present general approach to constipation treatment at endocrine diseases.

Key points. Defecation disorders on a background of endocrine diseases are regarded as secondary, symptomatic disorders. Constipation is a characteristic component of such endocrine syndromes, as diabetes mellitus (DM), hypothyroidism, hyperparathyroidism, hypopituitarism, pheochromocytoma, hyperaldosteronism, Addison's disease. DM occupies a leading place among them. Gastro-intestinal motility disorder at this syndrome is related to development of diabetic autonomous neuropathy, asynchrony of peristalsis and pressure of sphincters, acute decrease of cells of Cajal density, change of gastrointestinal hormones secretion. Constipation is typical symptom of hypothyroidism. Severe hypothyroidism can result in dynamic ileus and megacolon. Constipation is one of broad spectrum of gastro-intestinal hyperthyroidism manifestations, probably, related to change in expression of the genes regulating motility, decrease of autonomous nervous system excitability and dehydration. Decrease of enterochromaffin cells number and change of intestinal nervous ganglia structure is typical for hereditary endocrine syndromes (APECED, MEN-2). Disorders of defecation are observed at adrenal insufficiency (alternates with diarrhea), hyperaldosteronism, hypopituitarism, changes of sexual hormones secretion, hyperinsulinemia. Laxatives, including volume and osmotic laxatives, stimulating drugs, are prescribed in absence of response to nonpharmaceutical procedures.

Conclusion. Disorders of defecation is a characteristic symptom of the most common endocrine diseases; at some from them constipation alternates with diarrhea. Many endocrine diseases are oligosymptomatic for a long time. Doctor should pay special attention to constipation development and try to find other concomitant signs indicating systemic nature of disease. stepwise treatment of constipation is necessary.

About the Authors

Yu. O. Shulpekova
State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian Federation
Russian Federation


A. G. Komova
State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian Federation
Russian Federation


References

1. Авдеев В.Г. Диабетическая энтеропатия // Фарматека. – 2010. – № 3. – С. 46–49.

2. Внутренние болезни по Тинсли Р. Харрисону. – М.: Практика, 2002.

3. Румянцев В.Г. Запоры: тактика ведения пациента в поликлинике // Consilium Medicum. – 2002. – Т. 4, № 1.

4. Торшхоева Х.М., Ибрагимова Л.М, Зотова С.А., Микаберидзе Т.Н. К вопросам диагностики и лечения диабетической автономной нейропатии // http:// intensive.ru

5. Филиппов Ю. Гастроэнтерологические нарушения при диабетической нейропатии // Врач. – 2011. – № 4. – С. 96–101.

6. Abboud В., Daher R., Boujaoude J. Digestive manifestations of parathyroid disorders // World J. Gastroenterol.

7. – 2011. – Vol. 17, N 36. – P. 4063–4066.

8. Alemi F., Poole D.P., Chiu J. et al. The receptor Tgr5 mediates the prokinetic actions of intestinal bile acids and is required for normal defecation in mice // Gastroenterology. – 2012.-pii: S0016-5085(12)01456-4.

9. Bargren A.E., Repplinger D., Chen H., Sippel R.S. Can biochemical abnormalities predict symptomatology in patients with primary hyperparathyroidism? // J. Am. Coll. Surg. – 2011. – Vol. 213, N 3. – P. 410–414.

10. Bassotti G., Villanacci V., Bellomi A. et al. An assessment of enteric nervous system and estroprogestinic receptors in obstructed defecation associated with rectal intussusception // Neurogastroenterol. Motil. – 2012. – Vol. 24, N 3. – P. 155–161.

11. Battle W.M., Snape W.J.Jr., Alavi A. et al. Colonic dysfunction in diabetes mellitus // Gastroenterology. – 1980. – Vol. 79, N6. – P. 1217–1221.

12. Bertrand R.L., Senadheera S., Tanoto A. et al. Serotonin availability in rat colon is reduced during a Western diet model of obesity // Am. J. Physiol. Gastrointest. Liver. Physiol. – 2012. – Vol. 303, N 3. – P. 424–434.

13. Cheng L., Biancani P., Behar J. Progesterone receptor A mediates VIP inhibition of contraction. //Am. J. Physiol. Gastrointest. Liver. Physiol. – 2010. – Vol. 298, N 3. – P. 433–439.

14. Chmielewska А., Szajewska H. Systematic review of randomised controlled trials: Probiotics for functional constipation // World. J. Gastroenterol. – 2010. – Vol. 16, N 1. – P. 69–75.

15. Codario R.A. Type 2 diabetes, pre-diabetes, and the metabolic syndrome: the primary care guide to diagnosis and management. – Humana Press Inc., 2005.

16. Daher R., Yazbeck T., Jaoude J.B., Abboud B. Consequences of dysthyroid is monthe digestive tract and viscera // World. J. Gastroenterol. – 2009. – Vol. 15, N 23. – P. 2834–2838.

17. De Krijger R.R., Brooks A., van der Harst E. et al. Constipation as the presenting symptom in de novo multiple endocrine neoplasia type 2B // Pediatrics. – 1998. – Vol. 102. – P. 405–407.

18. Di Palma J.A., Halpert А. Guideline – 2008. Managing: Chronic constipation. Version 1.0. International Gudelines Center. www. guidelines@GuidelinesCenter.com.

19. Ellis C., Nicoloff D.M. Hyperparathyroidism and peptic ulcer disease // Arch. Surg. – 1968. – Vol. 96. – P. 114–118.

20. El-Salhy M., Sitohy B. Abnormal gastrointestinal endocrine cells in patients with diabetes type 1: relationship to gastric emptying and myoelectrical activity // Scand. J. Gastroenterol. – 2001. – Vol. 36, N 11. – P. 1162–1169.

21. Hamid S.A., di Lorenzo C., Reddy S.N. et al. Bisacodyl and high-amplitude-propagating colonic contractions in children // J. Pediatr. Gastroenterol. Nutr. – 1998. – Vol. 27. N 4. – P. 398–402.

22. Hsieh C. Treatment of constipation in older adults // Am. Fam. Physician. – 2005. – Vol. 72, N 11. – P. 2277–2284.

23. Hyperaldosteronism. http://medical-dictionary.thefree- dictionary.com/hyperaldosteronism.

24. Guarino M., Cheng L., Cicala M. et al. Progesterone receptors and serotonin levels in colon epithelial cells from females with slow transit constipation // Neurogastroenterol. Motil. – 2011 – Vol. 23, N 6. – P. 575.

25. Fernandes J.K., Klein M.J., Ater J.L. et al. Triiodothyronine supplementation for hypothalamic obesity // Metabolism. – 2002. – Vol. 51. N 11. – P. 1381–1383.

26. Foster T. Efficacy and safety of alpha-lipoic acid supplementation in the treatment of symptomatic diabetic neuropathy // Diabetes Educ. – 2007. – Vol. 33. – P. 111–117.

27. Kienzle-Horn S., Vix J.M., Schuijt C. et al. Efficacy and safety of bisacodyl in the acute treatment of constipation: a double-blind, randomized, placebo-controlled study // Aliment. Pharmacol. Ther. – 2006. – Vol. 23, N 10. – P. 1479–1488.

28. Kienzle-Horn S., Vix J.M., Schuijt C. et al. Comparison of bisacodyl and sodium picosulphate in the treatment of chronic constipation // Curr. Med. Res. Opin. – 2007. – Vol. 23, N 4. – P. 691–699.

29. Manabe N., Cremonini F., Camilleri M. et al. Effects of bisacodyl on ascending colon emptying and overall colonic transit in healthy volunteers // Aliment. Pharmacol. Ther. – 2009. – Vol. 30, N 9. – P. 930–936.

30. Nakahara M., Isozaki K., Hirota S. et al. Deficiency of KIT-positive cells in the colon of patients with diabetes mellitus // J. Gastroenterol. Hepatol. – 2002. – Vol. 17, N6. – P. 666–670.

31. Nicolaides N.C., Charmandari Е., Chrousos G.P. Adrenalin sufficiency // www.endotext.org/adrenal/adrenal13/adrenal13.htm

32. Palomba S., di Cello A., Riccio E. et al. Ovarian function and gastrointestinal motor activity // Minerva Endocrinol. – 2011. – Vol. 36, N 4. – P. 295–310.

33. Posovszky C., Lahr G., van Schnurbein J. et al. Loss of enteroendocrine cells in autoimmune-polyendocrinecandidiasis-ectodermal-dystrophy (APECED) syndrome with gastrointestinal dysfunction. //J. Clin. Endocrinol. Metab. – 2012. – Vol. 97, N 2. – P. 292–300.

34. Sharma S., Longo W.E., Baniadam B., Vernava A.M. Colorectal manifestations of endocrine disease // Dis. Colon Rectum. – 1995. – Vol. 38. – P. 318–323.

35. Spångéus A., El-Salhy M., Suhr O. et al. Prevalence of gastrointestinal symptoms in young and middle-aged diabetic patients // Scand. J. Gastroenterol. – 1999. – Vol. 34, N 12. – P. 1196–1202.

36. Stoll R.E., Blanchard K.T., Stoltz J.H. et al. Phenolphthalein and bisacodyl: assessment of genotoxic and carcinogenic responses in heterozygous p53 (+/–) mice and syrian hamster embryo (SHE) assay // Toxicol. Sci. – 2006. – Vol. 90, N 2. – P.440–450.

37. Wiriyakosol S., Kongdan Y., Euanorasetr C. et al. Randomized controlled trial of bisacodyl suppository versus placebo for postoperative ileus after elective colectomy for colon cancer // Asian J. Surg. – 2007. – Vol. 30, N 3. – P. 167–172.

38. Xiao Z.L., Biancani P., Behar J. Effects of progesterone on motility and prostaglandin levels in the distal guinea pig colon // Am. J. Physiol. Gastrointest. Liver. Physiol. – 2009. – Vol. 297, N 5. – P. 886–893.

39. Zingg U., Miskovic D., Pasternak I. et al. Effect of bisacodyl on postoperative bowel motility in elective colorectal surgery: a prospective, randomized trial // Int. J. Colorectal. Dis. – 2008. – Vol. 23, N 12. – P. 1175–1183.


Review

For citations:


Shulpekova Yu.O., Komova A.G. Constipation at endocrine diseases. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2013;23(2):79-85. (In Russ.)

Views: 136


ISSN 1382-4376 (Print)
ISSN 2658-6673 (Online)