Document Detail


Abnormal colonic motility: a possible association with urge fecal incontinence.
MedLine Citation:
PMID:  20305439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Fecal incontinence is a distressing condition affecting up to 7% of the population. Severe urgency is a symptom associated with hypersensitivity of the rectum, a common finding in both fecal incontinence and irritable bowel syndrome. The purpose of this study was to investigate whether patients with fecal incontinence, urgency, and rectal hypersensitivity have abnormal hindgut motility, suggestive of a more generalized motility problem. METHODS: Eleven females with urgency-associated incontinence and without anal sphincter injury were compared with 5 controls. After full clinical, ultrasonographic, and physiological assessment, patients underwent prolonged colonic manometry studies. Motility patterns were recorded and, in particular, the response to a standard gastrocolic reflex was noted. RESULTS: Rectal sensation values in patients were as follows: first sensation, 22 (range, 5-58) mls; desire to defecate, 31 (range, 13-166) mls; and maximum tolerated volume, 64 (range, 21-254) mls. Compared with controls, patients had significantly higher numbers of 1) low amplitude waves (>5 mmHg) in both the sigmoid colon (101 vs 46.5; P = .028) and the descending colon (101.5 vs 41; P = .036) in the hour before the meal stimulus, and 2) high amplitude waves (>50 mmHg) in the sigmoid colon (2 vs 0; P = .006) in the fasting state. CONCLUSION: Patients with fecal incontinence associated with severe urgency may have rectal hypersensitivity and a more global colonic motility problem similar to irritable bowel syndrome.
Authors:
Christopher J Rodger; Lorna Nicol; John H Anderson; Ruth F McKee; Ian G Finlay
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  53     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-22     Completed Date:  2010-05-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  409-13     Citation Subset:  IM    
Affiliation:
Department of Coloproctology, Glasgow Royal Infirmary, Glasgow, UK. chrodger@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Colon / physiopathology*
Defecation / physiology
Fecal Incontinence / physiopathology*
Female
Gastrointestinal Motility*
Gastrointestinal Transit
Humans
Manometry
Middle Aged
Statistics, Nonparametric

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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