Clinical, anorectal manometry and surface electromyography in the study of patients with fecal incontinence.
OBJECTIVE
to demonstrate the role of the clinical, anorectal manometry and surface electromyography in the assessment of patients with fecal incontinence.


METHODS
ninety-three patients with fecal incontinence are retrospectively reviewed and the data obtained from the directed clinical history, physical examination of the anal region, digital rectal examination, anorectal manometry and surface electromyography are analyzed. A treatment was administered in accordance with the alterations encountered and the results evaluated at 3 and 12 months.


RESULTS
fecal incontinence was predominant (91.4%) in women age 59.7+/-11. A background of obstetric risks (48.2%) was frequent in women. Also, 73.1% of the patients presented diarrhea. The anorectal manometry (ARM) demonstrated some alterations in 90.3% of the patients, whereas a hypotonic sphincter was the most common finding (85.7%). Rectal sensitivity or distensibility alterations were present in the rest of the patients. In 79.2% ofthe cases, hypotonic sphincter was associated with rectal sensitivity or distensibility alterations. In 65.2% of patients with hypotonic external anal sphincter, damage of the pudendal nerve was found and therefore biofeedback was indicated in 41.9% of them.


CONCLUSIONS
the clinical study of the patients, together with the anorectal manometry and surface electromyography enables the identification of the cause of FI and its treatment. These studies demonstrate that in most cases the origin of the incontinence is due to multiple etiologies, however the treatment of some of the factors involved frequently improves the symptomatology.
Muñoz Yagüe
T
T
Servicio de Medicina del Aparato Digestivo. Hospital Universitario 12 de Octubre. Madrid. Spain.
Alvarez Sánchez
V
V
Ibáñez Pinto
A
A
Solís- Herruzo
J A
JA
D000328:Adult; D000368:Aged; D004576:Electromyography / Q000379:methods; D005242:Fecal Incontinence / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D012007:Rectum; D012189:Retrospective Studies