To investigate the differences in electrogastroenterogram parameters among patients with different subtypes of functional constipation (FC), analyze their correlation with clinical features, and evaluate their diagnostic efficacy for subtypes of functional constipation.

A total of 104 patients with functional constipation admitted to the Third People’s Hospital of Chengdu from June 2023 to July 2024 were selected. According to the colonic transit test, there were 21 cases of slow-transit constipation (STC), forty-five cases of defecation disorder constipation (DD), and 38 cases of normal-transit constipation (NTC), no mixed type constipation patients diagnosed. Differences in gastrointestinal electromyography parameters and clinical pathological features among FC patients with different subtypes were compared; the correlation between gastrointestinal electromyography parameters and clinical pathological features was analyzed; multivariate Logistic regression analysis was used to identify factors influencing disease subtypes and gastrointestinal electromyography parameters; receiver operating characteristic (ROC) curves were drawn to evaluate the predictive value of gastrointestinal electromyography parameters for FC disease subtypes.

There are statistically significant differences among the three groups in the proportion of patients with different FC subtypes in terms of hard stools (χ²=6.309, P=0.043), straining during defecation (χ²=7.036, P=0.030), sensation of incomplete evacuation (χ²=6.378, P=0.041), and the need for manual assistance (χ²=16.788, P＜0.001) during defecation. Analysis of electrogastrography parameters showed that the average preprandial amplitude differed significantly among the three groups (F=33.354, P＜0.001), with the slow-transit constipation (STC) group being the lowest, the defecation disorder (DD) group the highest, and the normal-transit constipation (NTC) group in between. The postprandial/preprandial power ratio in the DD group was significantly higher than that in the STC group (t=2.259, P=0.027). Regarding intestinal electrogastrography parameters, the STC group showed the lowest preprandial amplitude, the highest percentage of rhythm disturbances, and the lowest postprandial increase; the DD group had the highest pre- and postprandial amplitudes and the highest postprandial power ratio, significantly higher than those in the STC group (t=3.806, P＜0.001; t=6.619, P＜0.001; t=7.796, P＜0.001). Analysis of the correlation between symptoms and parameters shows that hard stools are negatively correlated with preprandial intestinal electrical amplitude and frequency (r=−0.468, P=0.002; r=−0.518, P=0.009), while straining during defecation and the sensation of incomplete evacuation are positively correlated with the average preprandial gastric amplitude (r=0.614, P=0.015; r=0.394, P=0.013). Manual assistance for defecation is significantly positively correlated with the average postprandial intestinal amplitude and the postprandial/preprandial intestinal power ratio (r=0.691, P＜0.001; r=0.542, P＜0.001), and negatively correlated with the percentage of preprandial intestinal dysrthythmia (r=−0.453, P=0.023). For STC, the preprandial gastric average amplitude, postprandial/preprandial gastric power ratio, preprandial intestinal average amplitude, postprandial intestinal average amplitude, and postprandial/preprandial intestinal power ratio are independent protective factors, while preprandial intestinal dysrhythmia and postprandial intestinal dysrhythmia are independent risk factors; for DD, the preprandial gastric average amplitude, preprandial intestinal average amplitude, increased postprandial intestinal average amplitude, and postprandial/preprandial intestinal power ratio are independent risk factors; for NTC, the percentage of preprandial intestinal dysrhythmia and postprandial intestinal dysrhythmia are independent protective factors (all P＜0.05). ROC analysis further confirmed that the combined use of parameters such as pre-meal average amplitude, postprandial rhythm disturbance, and postprandial power ratio could significantly improve the prediction efficiency of STC, DD and NTC isotypes (the combined prediction AUC was 0.989, 0.934 and 0.947, respectively), and its effect was better than that of a single parameter.

Gastrointestinal electromyography parameters are correlated with the clinical characteristics of FC, and combining gastrointestinal electromyography parameters can effectively distinguish various subtypes, providing an important basis for non-invasive objective classification and precise diagnosis and treatment.