Document Detail


Manometric correlations of anorectal dysfunction and biofeedback outcome in patients with multiple sclerosis.
MedLine Citation:
PMID:  17942511     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate clinical and manometric characteristics of multiple sclerosis (MS) patients with anorectal dysfunction (ARD) and their influence on biofeedback outcome. PATIENTS AND METHODS: Patients were clinically and manometrically studied and compared with controls. Patients were subsequently offered to initiate biofeedback manoeuvres to improve ARD. RESULTS: Fifty-two patients with ARD, 39 women, mean age 44.96 +/- 9.26 years, mean Expanded Disability Status Scale 4.13 +/- 1.72, were evaluated. Thirty-one patients had relapsing-remitting (RR), 16 secondary progressive and five primary progressive MS. ARD complaints were constipation (67.3%), double ARD (23.1%) and isolated incontinence (9.6%). The manometric study showed significant differences in patients compared with controls in maximal contraction pressures (98.1 +/- 44.2 mm Hg versus 152.05 +/- 66.9 mm Hg, P < 0.001) and anal inhibitory reflex threshold (92.9 +/- 63.4 mL versus 40.45 +/- 11.3 mL, P < 0.001). Maximal pressure was lower in progressive forms compared with RR forms (83.1 +/- 36.2 mm Hg versus 108.2 +/- 46.7 mm Hg, P < 0.05) in relation to higher disability. Patients with paradoxical contraction (PC) (35 patients, 67.3%) showed more manometric disturbances. From a total of 18 patients performing biofeedback, those reporting some improvement (six complete, two partial) had milder manometric abnormalities. CONCLUSIONS: The most frequent manometric abnormalities in our MS patients with ARD were alterations of maximal pressures, anal inhibitory reflex and PC. Biofeedback could be more useful in patients with lower disability and manometric alterations.
Authors:
E Munteis; M Andreu; Je Martinez-Rodriguez; A Ois; F Bory; J Roquer
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-10-17
Journal Detail:
Title:  Multiple sclerosis (Houndmills, Basingstoke, England)     Volume:  14     ISSN:  1352-4585     ISO Abbreviation:  Mult. Scler.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-13     Completed Date:  2008-06-18     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  9509185     Medline TA:  Mult Scler     Country:  England    
Other Details:
Languages:  eng     Pagination:  237-42     Citation Subset:  IM    
Affiliation:
Neurology Service, Hospital del Mar, Departament de Medicina, Universitat Autònoma de Barcelona, IMAS, Barcelona, Spain. 91774@imas.imim.e
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MeSH Terms
Descriptor/Qualifier:
Adult
Biofeedback, Psychology*
Constipation / etiology,  physiopathology,  therapy
Defecation
Female
Humans
Male
Manometry*
Middle Aged
Multiple Sclerosis / complications*
Neural Inhibition
Pressure
Rectal Diseases / etiology,  physiopathology*,  therapy*
Rectum / innervation,  physiology
Reflex

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


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