| Relationship between symptoms and disordered continence mechanisms in women with idiopathic faecal incontinence. | |
| | |
MedLine Citation:
|
PMID: 15753542 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND AND AIMS: Anal sphincter weakness and rectal sensory disturbances contribute to faecal incontinence (FI). Our aims were to investigate the relationship between symptoms, risk factors, and disordered anorectal and pelvic floor functions in FI. METHODS: In 52 women with "idiopathic" FI and 21 age matched asymptomatic women, we assessed symptoms by standardised questionnaire, anal pressures by manometry, anal sphincter appearance by endoanal ultrasound and magnetic resonance imaging (MRI), pelvic floor motion by dynamic MRI, and rectal compliance and sensation by a barostat. RESULTS: The prevalence of anal sphincter injury (by imaging), reduced anal resting pressure (35% of FI), and reduced squeeze pressures (73% of FI) was higher in FI compared with controls. Puborectalis atrophy (by MRI) was associated (p<0.05) with FI and with impaired anorectal motion during pelvic floor contraction. Volume and pressure thresholds for the desire to defecate were lower, indicating rectal hypersensitivity, in FI. The rectal volume at maximum tolerated pressure (that is, rectal capacity) was reduced in 25% of FI; this volume was associated with the symptom of urge FI (p<0.01) and rectal hypersensitivity (p = 0.02). A combination of predictors (age, body mass index, symptoms, obstetric history, and anal sphincter appearance) explained a substantial proportion of the interindividual variation in anal squeeze pressure (45%) and rectal capacity (35%). CONCLUSIONS: Idiopathic FI in women is a multifactorial disorder resulting from one or more of the following: a disordered pelvic barrier (anal sphincters and puborectalis), or rectal capacity or sensation. |
| | |
Authors:
|
A E Bharucha; J G Fletcher; C M Harper; D Hough; J R Daube; C Stevens; B Seide; S J Riederer; A R Zinsmeister |
Publication Detail:
|
Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: Gut Volume: 54 ISSN: 0017-5749 ISO Abbreviation: Gut Publication Date: 2005 Apr |
Date Detail:
|
Created Date: 2005-03-08 Completed Date: 2005-04-11 Revised Date: 2009-11-18 |
Medline Journal Info:
|
Nlm Unique ID: 2985108R Medline TA: Gut Country: England |
Other Details:
|
Languages: eng Pagination: 546-55 Citation Subset: AIM; IM |
Affiliation:
|
Clinical Enteric Neuroscience Translational and Epidemiological Research Program (CENTER), Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. bharucha.adil@mayo.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Anal Canal / pathology, physiopathology*, ultrasonography Compliance Defecation Electromyography Fecal Incontinence / pathology, physiopathology*, ultrasonography Female Humans Magnetic Resonance Imaging / methods Manometry Middle Aged Pelvic Floor / physiopathology Pressure Rectum / innervation, physiopathology Risk Factors Sensation Severity of Illness Index |
| Grant Support | |
ID/Acronym/Agency:
|
M01 RR00585/RR/NCRR NIH HHS; R01 EB00212/EB/NIBIB NIH HHS; R01 HD38666/HD/NICHD NIH HHS; R01 HD41129/HD/NICHD NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Thalidomide in the treatment of cancer cachexia: a randomised placebo controlled trial.
Next Document: Microdissection and microcloning of plant chromosomes.