Anorectal function and visceral hypersensitivity in celiac disease.
OBJECTIVE
To evaluate anorectal function and rectal sensitivity thresholds in patients with celiac disease (CD).


METHODS
In 25 unselected patients with CD (16 female, 9 male; mean age 45, range 24 to 75 y) and 20 controls (12 female, 8 male; mean age 41, range 20 to 65 y) anorectal manometry and rectal balloon distension test were conducted using a 4 lumen water perfused catheter with a polyethylene balloon (Zinectics Manometric Catheter, Medtronic).


RESULTS
In celiac patients the maximal anal resting pressure, reflecting the internal anal sphincter function, was significantly higher than that in the controls: 87.8±21.7 mm Hg versus 66.7±15.2 mm Hg (P<0.001). There were no considerable differences between both the groups neither in the maximal anal squeeze nor in the cough pressures. Celiac patients had significantly lower first sensation threshold: 25.6±10.8 mL versus 37.5±12.5 mL (P<0.05). Visceral hypersensitivity (rectal pain/discomfort threshold ≤100 mL) was observed in 36% of celiac patients and in none of the controls (P<0.01).


CONCLUSIONS
The increased anal resting pressure and rectal hypersensitivity are observed in CD. Disturbances in gastrointestinal motility and visceral perception in the course of CD may occur at different levels of the brain-gut axis including direct changes in the enteric nervous system.
Mulak
Agata
A
Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland.
Waszczuk
Ewa
E
Paradowski
Leszek
L
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000294:innervation*; D016022:Case-Control Studies; D002404:Catheterization; D002446:Celiac Disease / Q000150:complications* / Q000503:physiopathology; D017615:Enteric Nervous System / Q000503:physiopathology; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010147:Pain Measurement; D011312:Pressure; D012007:Rectum / Q000294:innervation*; D012684:Sensory Thresholds; D014781:Viscera / Q000294:innervation*; D055815:Young Adult