Abnormalities in oesophageal, gastric and jejunal motility have been desaDbed in patients with chronic idiopathic constipation, suggesting that this may be a panenteric disorder. To test the hypothesis that ileal motility is also abnormal in constipation, terminal ileal motility was studied in ten patients and six healthy amtrols by prolonged and ambulant manometry. Mcan(s.e!.m.) phase II acbMty was significantly prolonged in patients compared with controls, during wakefulness (61.6(7-3) versus 193(3-5) per cent, PC0-001) and sleep (44.q9.0) versus 1-l(O.8) per cent, PCO.001). The mean(s.e.m.) duration of phase In Chronic idiopathic constipation is generally regarded as a colonic disorder. It is a common problem to which approximately 10 per cent of all referrals to coloproctology clinics relate'. The majority of patients are young women. The pathophysiology of the condition is not clear but factors such as reduced intake of fat and fibre, ps chological stress and anxiety are frequently implicated?-' and, recently, abnormalities in female sex hormones have been reported4.
Surgical treatment by subtotal colectomy or restorative proctocolectomy is often rec~mmended~.~ when increasing doses of laxatives fail to relieve symptoms. Relapse rates following surgery may be as high as 50 per cent, with 25 per cent of patients showing no improvement at all; this suggests possible involvement of the rest of the gastrointestinal tract'. Abnormal oesophageal, gastric and small intestinal motility together with reduced small bowel transit have all been reported *-'I.
Until recently, ileal motility has been recorded with a lowcompliance perfused-tube system in a laboratory ~etting'~-'~. The advent of portable technology has enabled measurement of gastrointestinal motility in the subject's normal environment under ambulant conditions 15-17. Motor abnormalities in the upper small intestine have been reported in patients with chronic idiopathic constipation through use of this techniqueI8. The present study examined the hypothesis that ileal motility is abnormal in these patients.