Pathogenetic Mechanisms of Peristalsis Disorders in Chronic Constipation

Abstract

INTRODUCTION: Chronic constipation is one of the most pressing problems in the contemporary coloproctology, which is observed in 14%–16% of the population of developed countries. The causes of chronic constipation widely vary from functional to organic. Pathogenesis of this syndrome is based on peristalsis disorders. AIM: Analysis and systematization of the relevant literature data on pathogenetic mechanisms of disorders in peristalsis in chronic constipation. Peristalsis is controlled by the influence of the sympathetic and parasympathetic divisions of the autonomic nervous system on the enteric nervous system. The latter, in turn, is regulated by a complex interaction of nerve cells (afferent, motor, mechanosensitive neurons, interneurons, glial cells) with auxiliary cells (enterochromaffin, interstitial, mast cells, fibroblasts, immune cells, endothelium). The intercellular relations provide homeostasis of ions, hormones and neurotransmitters. CONCLUSION: A disorder in any of the numerous regulatory mechanisms can lead to chronic constipation, and understanding of many-sided pathways of the pathogenesis of the disease will permit to justify and apply the best treatment methods.