The longitudinal high-pressure zone profile in patients with fecal incontinence.
OBJECTIVE
The aim of this study was to evaluate differences in the longitudinal high-pressure zone (HPZ) profile between incontinent patients and healthy controls.


METHODS
One hundred and fifty-six patients with fecal incontinence (mean age 63 yr; 139 women, 17 men) and 25 healthy controls (mean age 54 yr; 20 women, five men) underwent anorectal manometry with a perfused catheter using a station pull-through technique.


RESULTS
Maximum resting pressure (MRP) and maximum squeeze pressure (MSP) were lower in patients (p < 0.001) and the HPZ was shorter in patients (p < 0.05). The ratio MRP/sum of resting pressures within HPZ did not differ between the groups. The severity of incontinence measured as an incontinence score was correlated to MSP (p < 0.05) and sum of squeeze pressure within HPZ (p < 0.05), but not to any other variable. The relative pressure amount during rest in the distal half of HPZ was higher in controls (63% vs 56%, p < 0.05), but this was not seen during squeeze.


CONCLUSIONS
These results suggest that the main difference between incontinent patients and healthy controls is a greater magnitude of the pressure profile in the latter group. Furthermore, the relative pressure accumulation during rest tended to be more distally located within the HPZ.
Osterberg
A
A
Department of Surgery, University Hospital, Uppsala, Sweden.
Graf
W
W
Påhlman
L
L
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000503:physiopathology; D019841:Defecography; D004576:Electromyography; D005242:Fecal Incontinence / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011312:Pressure; D012007:Rectum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015203:Reproducibility of Results; D014463:Ultrasonography