Fecoflowmetry in fecal incontinence.

The fecoflowmetric pattern of fecal incontinence was studied in 38 patients. 21 patients had complete and 17 partial incontinence. Twenty normal controls of matching sex and age were also studied. EMG of external anal sphincter and puborectalis as well as the measuring of anal pressure were done. The fecal flow rate was determined by means of the fecoflowmeter. In complete incontinence, the EMG of the rectal sphincters showed no activity, and the anal pressure was lower than controls at rest and on squeezing (p less than 0.0001). The fecoflowgram showed as 'minicurve' because the patients had leaked most of the enema before the test started. In partial incontinence the enema before the test started. In partial incontinence EMG of the sphincters showed subnormal activity on squeezing. The anal pressure recorded values lower than in the normal controls at rest (p less than 0.001) and on voluntary squeezing (p less than 0.0001), though they were higher than those of complete incontinence. The flow rate parameters and curve were characteristics. The evacuated volume as well as the mean and maximum flow rate were higher (p less than 0.001), while the flow time (p less than 0.001) and the time to maximum flow (p less than 0.01) were shorter than in normal subjects. The ascending limb of the flow curve rose more steeply and was smooth. There was no plateau. The descending limb sloped more gradually and showed fluctuations. Fecoflowmetry could thus be an investigative tool not only in diagnosing but also in identifying the type of fecal incontinence.