Anorectal dysfunction in patients with ulcerative colitis: impaired adaptation or enhanced perception?
BACKGROUND
Rectal disorders during ulcerative colitis (UC) drastically alter the quality of life and may result from an impairment of rectal perception and compliance. This study aims to assess anorectal disorders in patients with mild-to-moderate UC.


METHODS
Anal pressures and the rectal responses to phasic rectal isobaric distension in 10 patients with mild-to-moderate UC were prospectively compared with those in 10 healthy volunteers (HVs).


RESULTS
The patients in each group were similar regarding age, gender, and delivery. In the resting state, the anal canal pressures were similar between the groups. Only the squeeze pressures of the lower anal canal were significantly lower in UC patients than in HVs. During phasic isobaric distension, rectal sensitivity was similar between the groups, whatever the step of distension. Isobaric rectal distension resulted in a significant decrease of the rectoanal inhibitory reflex and a decrease in rectal tone and a significant drop in rectal compliance in UC patients compared with HVs.


CONCLUSIONS
Patients showing mild-to-moderate UC experience rectal compliance and innervation disorders without a significant change in rectal sensitivity. The findings of this work suggest impairment not only of the properties of the rectal wall but also of intrinsic innervation. Repeated evaluation over time may be helpful for analyzing the reversibility of the process after healing.
Service des Maladies de l'Appareil Digestif, CHU Pontchaillou, Université de Rennes 1, Rennes, France.|Services d'Explorations Fonctionnelles Digestives, CHU Pontchaillou, Université de Rennes 1, Rennes, France.|INSERM U991, Université de Rennes, Rennes, France.
C
C
Brochard
Service des Maladies de l'Appareil Digestif, CHU Pontchaillou, Université de Rennes 1, Rennes, France.|INSERM U991, Université de Rennes, Rennes, France.
L
L
Siproudhis
Services d'Explorations Fonctionnelles Digestives, CHU Pontchaillou, Université de Rennes 1, Rennes, France.
A
A
Ropert
Service des Maladies de l'Appareil Digestif, CHU Pontchaillou, Université de Rennes 1, Rennes, France.
A
A
Mallak
Service des Maladies de l'Appareil Digestif, CHU Pontchaillou, Université de Rennes 1, Rennes, France.
J-F
JF
Bretagne
Service des Maladies de l'Appareil Digestif, CHU Pontchaillou, Université de Rennes 1, Rennes, France.|INSERM U991, Université de Rennes, Rennes, France.
G
G
Bouguen
D000328:Adult; D001003:Anal Canal / Q000503:physiopathology*; D003093:Colitis, Ulcerative / Q000503:physiopathology*; D005242:Fecal Incontinence / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D058748:Pain Perception / Q000502:physiology*; D012007:Rectum / Q000503:physiopathology*
incontinence; isobaric distension; perception; ulcerative colitis