Anorectal pressure gradient and rectal compliance in fecal incontinence |
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Authors: | O Ø Rasmussen C Rønholt N Alstrup J Christiansen |
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Institution: | (1) Department of Surgery D, Herlev Hospital, University of Copenhagen, DK-2730 Herlev, Denmark, Tel.: 0045-44-88-36-04; Fax: 0045-44-88-44-89, DK |
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Abstract: | To study whether anorectal pressure gradients discriminated better than standard anal manometry between patients with fecal
incontinence and subjects with normal anal function, anorectal pressure gradients were measured during rectal compliance measurements
in 36 patients with fecal incontinence and in 22 control subjects. Anal and rectal pressures were measured simultaneously
during the rectal compliance measurements. With standard anal manometry, 75% of patients with fecal incontinence had maximal
resting pressure within the normal range, and 39% had maximum squeeze pressure within the normal range. Anorectal pressure
gradients did not discriminate better between fecal incontinence and normal anal function, since, depending on the parameters
used, 61%–100% of the incontinent patients had anorectal pressure gradients within the normal range. Patients with fecal incontinence
had lower rectal volumes than controls at constant defecation urge (median 138 ml and 181 ml, P<0.05) and at maximal tolerable volume (median 185 ml and 217 ml, P<0.05). We conclude that measurements of anorectal pressure gradients offer no advantage over standard anal manometry when
comparing patients with fecal incontinence to controls. Patients with fecal incontinence have a lower rectal volume tolerability
than control subjects with normal anal function.
Accepted: 5 June 1998 |
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Keywords: | Anal physiology Anal manometry Rectal compliance Fecal incontinence |
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