260 - National Estimates of 30-Day Readmissions Among Adult Patients Hospitalized for Constipation in the United States: An Analysis of the Nationwide Readmission Database

complete the study.32 constipated patients had features of pelvic floor dysfunction (abnormal balloon expulsion time (n=16), defecography (n=7), manometry (n=6), and anal surface EMG (n=3)).Constipation was associated with higher anxiety (OR 1.6; 95% CI 1.3-1.9)and depression scores (OR 2.3;).With one exception, provided below, effects of perturbations are not significantly different between healthy and constipated people; hence data are combined in one table.During mental stress, participants reported feeling more tense and energetic, and anal resting pressure increased (p<0.001).The increased pressure was sustained for the entire 6 minute maneuver.By contrast, mental relaxation reduced psychosensory arousal in all people, but decreased anal pressure (p=0.0004) in constipated patients only.Compared to placebo, alfuzosin markedly reduced anal resting pressure by 38% (vs 18% in placebo) but no other parameters.In the alfuzosin treated group anal pressure also increased during Stroop, but not during mental arithmetic or relaxation.Conclusion: Mental stress increased anal pressures in healthy and constipated people.This increment was modest, but prolonged, suggesting internal sphincter contraction.Conceivably, mental stress may hinder evacuation in some people.By contrast, relaxation reduced anal pressures in constipated people.Alfuzosin markedly reduced anal resting tone, confirming tonic a 1 -mediated adrenergic excitatory input to the internal sphincter, but did not prevent the stress-induced contractile response.The effects of alfuzosin on rectal evacuation deserve further study.Summary statistics a p <0.001 vs resting pressure before treatment (within group, ie, alfuzosin or placebo), b p<0.05 for the change (i.e.after-before treatment) in resting pressure between alfuzosin and placebo c p< 0.001 vs before stressors d p< 0.001, e p<0.05 for change (i.e., Before vs During) in VAS score during maneuver f p<0.05 for change in VAS score (relative to baseline) between alfuzosin and placebo 258