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Low rectal volumes in patients suffering from fecal incontinence: what does it mean?
Author(s) -
SIPROUDHIS L.,
EL ABKARI M.,
EL ALAOUI M.,
JUGUET F.,
BRETAGNE J. F.
Publication year - 2005
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2005.02675.x
Subject(s) - barostat , rectum , medicine , fecal incontinence , distension , anal canal , defecation , sensory threshold , urology , gastroenterology , psychology , cognitive science
Summary Background : Rectal perception and adaptation to distension are widely heterogeneous in subjects with faecal incontinence. Aim : To quantify rectal physiology in patients with incontinence and low maximum rectal volume, according to AGA guidelines on anorectal testing techniques. Patients and methods : 148 patients (12 men, 136 female) with incontinence to liquid and/or solid stools were investigated. Distending isobaric procedures were carried out using an electronic barostat in order to analyse perception and adaptation of the rectum. Results : Pain during isovolumic rectal distension at a level of 100 mL or less was experienced in 21 subjects (14.2%). As defined by isobaric distensions, incontinent patients with low MTV had more frequently a hypocompliant rectum (62%) when compared with those with higher MTV (31%, P = 0.046). Perception scores tended to be higher at each step of distending rectal pressure: incontinent patients with low MTV had more frequently a hypersensitive rectum (48%) when compared with those with normal or high MTV (24%, P = 0.035). Only four of 21 incontinent subjects with low MTV had an isolated hypersensitive rectum. Conclusion : Both sensitivity and compliance are altered in patients with low MTV. A more extensive study of the role of sensory and compliance aspects of subjects with incontinence is warranted.