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.
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, incontinentpatients 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: incontinentpatients 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.
Authors: Adil E Bharucha; Gena Dunivan; Patricia S Goode; Emily S Lukacz; Alayne D Markland; Catherine A Matthews; Louise Mott; Rebecca G Rogers; Alan R Zinsmeister; William E Whitehead; Satish S C Rao; Frank A Hamilton Journal: Am J Gastroenterol Date: 2014-12-23 Impact factor: 10.864
Authors: Adil E Bharucha; Charles H Knowles; Isabelle Mack; Allison Malcolm; Nicholas Oblizajek; Satish Rao; S Mark Scott; Andrea Shin; Paul Enck Journal: Nat Rev Dis Primers Date: 2022-08-10 Impact factor: 65.038
Authors: Satish Sc Rao; Adil E Bharucha; Giuseppe Chiarioni; Richelle Felt-Bersma; Charles Knowles; Allison Malcolm; Arnold Wald Journal: Gastroenterology Date: 2016-03-25 Impact factor: 22.682