Anorectal manometry and defecography in the diagnosis of fecal incontinence.
We carried out anorectal manometry and defecography prospectively in 43 consecutive patients with fecal incontinence. A subgroup of 17 patients with severe incontinence was identified radiologically by a short and incompletely closed anal canal. In these patients, the anal resting pressure was significantly lower than in the rest of the group (34.9 +/- 11.4 mm Hg versus 60.0 +/- 25.7 mm Hg, respectively; p less than 0.01). The anorectal angle did not change in 24 patients during squeezing, indicating a dysfunction of the puborectalis muscle. Manometric data did not differ between this subgroup and patients with a more acute anorectal angle during voluntary sphincter contraction. This indicates that the anal pressures recorded manometrically do not reflect the function of a muscular component that is important in the maintenance of fecal continence. We conclude that anorectal manometry and defecography are complementary diagnostic tools in the investigation of patients with fecal incontinence.
Bielefeldt
K
K
Department of Gastroenterology, Heinrich-Heine University, Düssldorf, Germany.
Enck
P
P
Zamboglou
N
N
Moedder
U
U
Erckenbrecht
J F
JF
D000328:Adult; D001003:Anal Canal / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003672:Defecation; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011312:Pressure; D011859:Radiography; D012007:Rectum / Q000000981:diagnostic imaging* / Q000503:physiopathology*