Rectal hyposensitivity and functional anorectal outlet obstruction are common entities in patients with functional constipation but are not significantly associated.
OBJECTIVE
The causes of functional anorectal outlet obstruction (outlet obstruction) include functional defecation disorder (FDD), rectocele, and rectal intussusception (RI). It is unclear whether outlet obstruction is associated with rectal hyposensitivity (RH) in patients with functional constipation (FC). The aim of this study was to determine the association between RH and outlet obstruction in patients with FC.


METHODS
This was a retrospective study using a prospectively collected constipation database, and the population comprised 107 patients with FC (100 females; median age, 49 years). We performed anorectal manometry, defecography, rectal barostat, and at least two tests (balloon expulsion test, electromyography, or colon transit time study). RH was defined as one or more sensory threshold pressures raised beyond the normal range on rectal barostat. We investigated the association between the presence of RH and an outlet obstruction such as large rectocele (> 2 cm in size), RI, or FDD.


RESULTS
Forty patients (37.4%) had RH. No significant difference was observed in RH between patients with small and large rectoceles (22 [44.9%] vs. 18 [31%], respectively; p = 0.140). No significant difference was observed in RH between the non-RI and RI groups (36 [36.7%] vs. 4 [30.8%], respectively; p = 0.599). Furthermore, no significant difference in RH was observed between the non-FDD and FDD groups (19 [35.8%] vs. 21 [38.9%], respectively; p = 0.745).


CONCLUSIONS
RH and outlet obstruction are common entities but appear not to be significantly associated.
Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Tae Hee
TH
Lee
Joon Seong
JS
Lee
Su Jin
SJ
Hong
Seong Ran
SR
Jeon
Soon Ha
SH
Kwon
Wan Jung
WJ
Kim
Hyun Gun
HG
Kim
Won Young
WY
Cho
Joo Young
JY
Cho
Jin-Oh
JO
Kim
Ji Sung
JS
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001004:Anus Diseases / Q000175:diagnosis / Q000503:physiopathology*; D003248:Constipation / Q000175:diagnosis / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003672:Defecation; D019841:Defecography; D004576:Electromyography; D005260:Female; D006801:Humans; D007443:Intussusception / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011312:Pressure; D020047:Rectocele / Q000175:diagnosis / Q000503:physiopathology*; D012007:Rectum / Q000294:innervation*; D012189:Retrospective Studies; D012684:Sensory Thresholds; D055815:Young Adult
Functional defecation disorder; Intussusception; Rectal hyposensitivity; Rectocele