title: Anorectal function and visceral hypersensitivity in celiac disease.
abstract: 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.
authors.affiliation: Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Mulak
authors.forename: Ewa
authors.initials: E
authors.lastname: Waszczuk
authors.forename: Leszek
authors.initials: L
authors.lastname: Paradowski
mesh_terms: 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