title: Assessment of anorectal function in selection of patients for ileorectal anastomosis in Crohn's colitis.
abstract: Anorectal function has been assessed in 53 patients with Crohn's disease by measurement of resting and squeeze anal canal pressures and the maximum volume tolerated during distension of a balloon in the rectum. Radiographs of the rectum from barium enema examination were also reviewed to assess rectal capacity. Thirty-three patients have had a colectomy and ileorectal anastomosis for Crohn's colitis of whom 13 now have a stoma because they either required a protectomy (n=9) or where closure of a loop ileostomy had not been possible (n=4) because of severe anorectal disease. The maximum tolerated volume was less than 150 ml in 12 of 13 patients who now have a stoma compared with none of the 20 patients who have a functioning anastomosis. Although the correlation between a radiological assessment of rectal capacity and the maximum tolerated volume was poor, a severely contracted rectum was associated with the need for a stoma in six of seven patients compared with only two of 13 patients who did not have radiological signs of a narrow rectum.
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000503:physiopathology*; D003092:Colitis / Q000503:physiopathology / Q000601:surgery; D003424:Crohn Disease / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012007:Rectum / Q000503:physiopathology* / Q000601:surgery