Korean J Intern Med.  2013 Jan;28(1):54-61. 10.3904/kjim.2013.28.1.54.

Rectal hyposensitivity and functional anorectal outlet obstruction are common entities in patients with functional constipation but are not significantly associated

• Lee TH
• Lee JS
• Hong SJ
• Jeon SR
• Kwon SH
• Kim WJ
• Kim HG
• Cho WY
• Cho JY
• Kim JO
• Lee JS

• KMID: 1793219
• DOI: http://doi.org/10.3904/kjim.2013.28.1.54

Abstract

BACKGROUND/AIMS
The causes of functional anorectal outlet obstruction (outlet obstruction) include functional defecation disorder (FDD), rectocele, and rectal intussusception (RI). It is unclear whether outlet obstruction is associated with rectal hyposensitivity (RH) in patients with functional constipation (FC). The aim of this study was to determine the association between RH and outlet obstruction in patients with FC.
METHODS
This was a retrospective study using a prospectively collected constipation database, and the population comprised 107 patients with FC (100 females; median age, 49 years). We performed anorectal manometry, defecography, rectal barostat, and at least two tests (balloon expulsion test, electromyography, or colon transit time study). RH was defined as one or more sensory threshold pressures raised beyond the normal range on rectal barostat. We investigated the association between the presence of RH and an outlet obstruction such as large rectocele (> 2 cm in size), RI, or FDD.
RESULTS
Forty patients (37.4%) had RH. No significant difference was observed in RH between patients with small and large rectoceles (22 [44.9%] vs. 18 [31%], respectively; p = 0.140). No significant difference was observed in RH between the non-RI and RI groups (36 [36.7%] vs. 4 [30.8%], respectively; p = 0.599). Furthermore, no significant difference in RH was observed between the non-FDD and FDD groups (19 [35.8%] vs. 21 [38.9%], respectively; p = 0.745).
CONCLUSIONS
RH and outlet obstruction are common entities but appear not to be significantly associated.

Keyword

Functional defecation disorder; Intussusception; Rectocele; Rectal hyposensitivity

MeSH Terms

Adult
Aged
Aged, 80 and over
Anus Diseases/diagnosis/*physiopathology
Constipation/diagnosis/*physiopathology
Cross-Sectional Studies
*Defecation
Defecography
Electromyography
Female
Humans
Intussusception/diagnosis/*physiopathology
Male
Manometry
Middle Aged
Pressure
Rectocele/diagnosis/*physiopathology
Rectum/*innervation
Retrospective Studies
*Sensory Thresholds
Young Adult