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PubMedDate not supplied

Evaluation of biofeedback in childhood encopresis.

In order to evaluate the efficacy of biofeedback for childhood encopresis, 50 children with encopresis were prospectively studied and randomized to receive biofeedback (B) or mineral oil therapy (M). Specificity of biofeedback was also evaluated by comparing outcomes of both regimens in children with normal (n = 32) and abnormal (n = 18) defecation patterns. Using a single blinded design, there were no significant differences in clinical outcomes between the 24 children receiving B and the 26 children receiving M at 3, 6, and 12 months. However, at 12 months six of nine children with abnormal defecation patterns were in remission or markedly improved after receiving B, compared to only three of nine children receiving M. In contrast, children with normal patterns appeared to respond better to M than did those receiving B (71 vs. 40% at 12 months). Biofeedback appears to warrant further evaluation in children with encopresis and abnormal defecation patterns.

Adolescent↗
PubMed2000

Anorectal and bladder function after sacrifice of the sacral nerves.

STUDY DESIGN: The quantitative changes in anorectal and bladder functions after sacrifice of the sacral nerves were assessed. OBJECTIVES: To evaluate the bladder and anorectal functions before and after sacral nerve division in patients with sacral bone tumors. SUMMARY OF BACKGROUND DATA: The quantitative changes in bladder and anorectal functions after sacrifice of the sacral nerves have not been intensively studied. The purpose of this investigation was to measure the bladder and anorectal function before and after sacral nerve division using manometry and cystometry. METHODS: Surgical resection of a sacral tumor was performed in five patients. The sacral nerves were sacrificed bilaterally in three patients and unilaterally in two patients. Anorectal function was evaluated on the basis of symptoms and physiologic tests. Micturition function was evaluated based on symptoms, and intravesical pressures were measured by cystometry. RESULTS: The two patients with unilateral sacral nerve loss did not experience subjective problems with defecation or micturition, although the residual volume of urine was increased after surgery. Two of the three patients with bilateral sacral nerve loss had no urge to defecate, were unable to differentiate between feces and flatus, and experienced no urgency. Fecal incontinence was uncommon because of firm feces. It was possible to control defecation using enemas on alternate days. The third patient underwent colostomy because the maximum resting pressure, which is controlled by the hypogastric nerves, was affected before surgery. CONCLUSION: Unilateral sacrifice of sacral nerves results in little bladder or anorectal dysfunction.

Adult↗
PubMed2006

Constipation of anorectal outlet obstruction: pathophysiology, evaluation and management.

Constipation is a subjective symptom of various pathological conditions. Incidence of constipation fluctuates from 2 to 30% in the general population. Approximately 50% of constipated patients referred to tertiary care centers have obstructed defecation constipation. Constipation of obstructed defecation may be due to mechanical causes or functional disorders of the anorectal region. Mechanical causes are related to morphological abnormalities of the anorectum (megarectum, rectal prolapse, rectocele, enterocele, neoplasms, stenosis). Functional disorders are associated with neurological disorders and dysfunction of the pelvic floor muscles or anorectal muscles (anismus, descending perineum syndrome, Hirschsprung's disease). However, this type of constipation should be differentiated by colonic slow transit constipation which, if coexists, should be managed to a second time. Assessment of patients with severe constipation includes a good history, physical examination and specialized investigations (colonic transit time, anorectal manometry, rectal balloon expulsion test, defecography, electromyography), which contribute to the diagnosis and the differential diagnosis of the cause of the obstructed defecation. Thereby, constipated patients can be given appropriate treatment for their problem, which may be conservative (bulk agents, high-fiber diet or laxatives), biofeedback training or surgery.

Anus Diseases↗
PubMed2000

A comparison of the Rome and Manning criteria for case identification in epidemiological investigations of irritable bowel syndrome.

OBJECTIVE: The aim of this study was to estimate the prevalence of irritable bowel syndrome using different standard definitions (Rome and Manning criteria) and to determine the degree of agreement between these definitions. METHODS: A population-based, cross-sectional survey study was conducted by mailing a valid, reliable questionnaire to an age- and gender-stratified random sample of residents of Olmsted County, MN, aged 30-69 yr. The threshold for a positive diagnosis of irritable bowel was varied from two to four of the six Manning criteria and from two to three of the five defecation disorders in the Rome criteria. Unadjusted as well as age- and gender-adjusted prevalence rates were calculated for each of the five definitions of IBS. Percent agreement and kappa statistics were calculated to assess agreement between the definitions. RESULTS: Questionnaires were returned by 643 of 892 eligible subjects (72% response rate). The age- and gender-adjusted prevalence of IBS varied from 20.4% using a threshold of two symptoms in the Manning criteria to 8.5% using a threshold of three defecation disorders in the Rome criteria. The percent agreement for each comparison of Manning and Rome definitions was always >90%. The kappa values ranged from 0.55 to 0.78, with the best agreement occurring between a threshold of three symptoms of Manning and two defecation disorders in Rome. CONCLUSIONS: The prevalence of IBS varied substantially depending on the specific definition of IBS used. The range of prevalence estimates in Olmsted County was similar to other published figures when IBS definition was accounted for. These findings are useful in interpreting epidemiological and clinical studies of IBS.

Adult↗
PubMed1988

Urological abnormalities in young women with severe constipation.

Anorectal and urodynamic studies were carried out in 10 young women with severe constipation and the results compared with those obtained in controls. The lowest volumes that provoked a desire to defecate (constipated 200 +/- 50 v controls 110 +/- 10 [mean +/- SEM] ml: p less than 0.05), and a desire to micturate (constipated 560 +/- 40 v controls 295 +/- 15 [mean +/- SEM] ml: p less than 0.001), were significantly greater in constipated patients compared with controls. The maximum tolerable rectal volume (380 +/- 30 v 290 +/- 20 [mean +/- SEM] ml: p less than 0.05) and the bladder capacity (720 +/- 50 v 540 +/- 10 [mean +/- SEM] ml: p less than 0.001) were also increased in the constipated subjects compared with controls. Electromyographic studies show failure of relaxation of the external anal sphincter (EAS) on attempted defecation in all 10 patients; and eight of these patients actually contracted their EAS when they strained to defecate, causing a functional outlet obstruction. Urodynamic studies showed normal urinary flow rates, normal detrusor pressures and normal radiology during voiding. Thus, these studies suggest that constipated patients have an increase in capacity and a reduction in sensitivity in the urinary bladder as well as in the rectum, but showed no evidence of obstruction to urine flow.

Adult↗
PubMed1989

Effect of bile acid on anorectal function in man.

The effects of rectal infusions (500 ml) of deoxycholic acid (1 mmol/l, 3 mmol/l) or normal saline on basal anorectal motility and responses to rectal distension were studied in 11 normal volunteers. Deoxycholic acid (1 mmol/l) did not alter anorectal motor patterns under basal conditions but reduced the rectal volumes required to induce a desire to defecate (deoxycholic acid 76 (12) ml v saline 123 (12) ml; mean (SEM) p less than 0.01), and to produce anal relaxation (deoxycholic acid 83 (14) ml v saline 152 (24) ml; p less than 0.05) and perception of the rectal balloon (deoxycholic acid 56 (10) ml v saline 104 (17) ml; p less than 0.01) that were sustained for the period of distension (1 min). Seven of 10 subjects could not tolerate an infusion of 3 mmol/l deoxycholic acid. Between two and 30 minutes after the start of the infusion they experienced an extreme urge to defecate which was associated with large amplitude pressure waves in the rectal channels (amplitude 30 (5) mmHg, duration 0.7 (0.1) min, frequency 1.7 (0.4)/min). Such contractions were never seen during saline infusion. Thus, rectal infusion of deoxycholic acid at physiological concentrations increases the sensitivity of the rectum to distension, and promotes an urgent desire to defecate in normal subjects.

Adolescent↗
PubMed1992

Anorectal function in patients with complete supraconal spinal cord lesions.

Anorectal manometry and sphincter electromyography were performed in 23 patients with complete supraconal traumatic spinal injuries and 30 age and sex matched control subjects. Basal pressures in the spinal group were similar to those in normal subjects but conscious control of sphincter activity was abolished in all spinal patients. Discriminant rectal sensation was also abolished during rectal distension, but 40% of patients experienced a dull pelvic ache at maximum levels of distension. Phasic rectal contraction and anal relaxation were present but exaggerated and induced at lower distending volumes than in normal subjects. The configuration of the rectal pressure/volume relationship was linear in patients compared with a reversed 'S' shape in normal subjects. The external anal sphincter response to rectal distension was noticeably attenuated, reinforcing the view that this spinal reflex is heavily modulated by supraspinal centres under normal circumstances. The external anal sphincter response to increases in abdominal pressure was also attenuated, and the anal pressures were strongly correlated with the level of the lesion and the abdominal pressure the patient could generate. No spinal patient showed a decrease in external anal sphincter activity during straining 'as if to defecate.' The exaggerated anorectal smooth muscle responses to rectal distension and the attenuated external sphincter response explain why patients with complete supraconal spinal lesions experience uncontrollable reflex defecation, while the persistance of external and sphincter contraction and the absence of any external anal sphincter relaxation during straining 'as if to defecate' might explain the difficulty that these patients have in consciously expelling rectal contents.

Adolescent↗
PubMed1983

Parental methadone treatment: a multigenerational study of development and behavior in offspring.

After 60 days of treating both sexes with daily oral doses of 15 mg/kg methadone hydrochloride, Wistar rats were mated. Drug treatment of females continued until the weaning of their pups. The body weight of pups was reduced compared to controls up to weaning, and viability was significantly decreased. Ontogeny of reflexes was delayed, and exploration in an open-field arena was reduced up to 2 weeks of age, but then increased above controls. Defecation in the open-field arena was lessened. When only the sire received methadone, only the increase in exploratory behavior and the decrease in defecation occurred. Breeding offspring (F1) of which both parents had methadone treatment gave F2 generation offspring for which neonatal mortality was significantly elevated and defecation in the open-field arena was lessened at 21 days. No changes clearly traceable to methadone were found in the subsequent F3 generation. Some F3 generation rats were treated with methadone and bred in the same manner as the original parental generation. The resulting pups, having the genealogy twice-exposed to methadone, were not significantly different from those whose immediate parents only received the drug.

Animals↗
PubMed2004

Differences in open field behavior between heterozygous and homozygous negative gilts for the RYR(1) gene.

A test widely used to assess fear and novelty responses in domestic species is the open field. The aim of this study was to investigate the effect of RYR(1) genotype on open field behavior in growing pigs. The study subjected 15 heterozygous (Nn) and 15 RYR(1)-free (NN) gilts of 19 weeks of age to 3 replicates of an open field test 2 days apart from each other. The study measured the number of grid lines crossed and defecation score in the test arena. There was a significant individual correlation among the 3 replicates of the test, both for number of grid lines crossed and defecation score (p <.05). RYR(1) genotype had a significant effect on number of grid lines crossed, with NN gilts showing more overall activity than Nn gilts (p <.05). The study observed no significant differences in defecation score between genotypes. This result suggests that the RYR(1) genotype may have an effect on the appraisal of novelty. Thus, it would be interesting to take this factor into account when using this methodology to assess fear responses in pigs and in interpreting the results with respect to welfare.

Animal Husbandry↗
PubMed2005

[Prevalence and factors associated with intestinal constipation in postmenopausal women].

BACKGROUND: Constipation occurs more frequently in the female population and it becomes more prevalent with increasing age. There are few studies that have assessed the prevalence of constipation in postmenopausal women. AIM: To investigate the prevalence and factors associated with constipation in postmenopausal women. PATIENTS AND METHODS: A cross-sectional study of postmenopausal women aged over 45 years was conducted. It included 100 women who sought medical attention at the Menopause Outpatient Facility at the State University of Campinas (UNICAMP), Campinas, SP, Brazil, between March, 2003 and January, 2004. The prevalence of constipation was assessed according to the Rome II criteria. Sociodemographic and clinical features of these patients were studied. Physical examinations were performed to evaluate genital dystopias and anal sphincter tone. Statistical analysis was performed by using the mean, standard deviation, median, relative and absolute frequencies and by using the prevalence ratio with a 95% confidence interval and multiple logistic regression. RESULTS: The mean age of the participants was 58.9 +/- 5.9 years and the mean age was 47.5 +/- 5.4 years at menopause. The prevalence of constipation was 37%, the most common symptom being excessive straining when defecating (91.9%), followed by a feeling of incomplete evacuation (83.8%), hard or lumpy stools (81.1%), less than three bowel movements per week (62.2%), sensation of anorectal obstruction during defecation (62.2%) and digital maneuvers to facilitate defecation (45.9%). Bivariate analysis showed that anal sphincter tone and the history of perianal surgery were factors associated with constipation. After applying multiple regression analysis, the history of perianal surgery was significantly associated with constipation (prevalence ratio: 2.68; 95% confidence interval: 1.18-6.11). CONCLUSIONS: The prevalence of constipation in postmenopausal women was high. The history of perianal surgery was significantly associated with constipation, even when the influence of other variables were taken into consideration.

Brazil↗
PubMedDate not supplied

[Constipation in infants: influence of type of feeding and dietary fiber intake].

OBJECTIVE: To study the relationship between breast-feeding, dietary fiber intake and constipation in infants. METHODS: The study population consisted of 275 infants consecutively enrolled in two Primary Care Clinic in the city of Embu, in the Great São Paulo. The feeding pattern were classified in predominantly breast-feeding, partially breast and cow's milk feeding and artificial feeding. Constipation was defined by the elimination of hard stool associated with one of the following: painful or difficult defecation, hard or round cracked stools and less than three defecations a week. False constipation was defined by the elimination of soft stools without pain or difficulty but with less than three defecations a week. RESULTS: Constipation was found in 25.1% (69/275). False constipation was found only in the first semester of life in 5.1% of 159 infants. The prevalence of constipation was higher between 6 and 24 months (38.8%, 45/116) than in the first semester of life (15.1%, p=0.000). A model of logistic regression demonstrated that infants under artificial feeding were 4.53 times more liable to develop constipation than infants who were predominantly breastfed. The daily dietary fiber intake (g/day) was similar (p=0.57) among the constipated (median=9.0 g; 25th and 75th percentiles: 6.9-13.1 g) and non-constipated (median=8.8 g; 25th and 75th percentiles: 6.1-12.9 g). CONCLUSIONS: Dietary fiber intake was similar in constipated and non-constipated infants. Breast-feeding serves as a protection factor against the development of constipation in the first semester of life.

English Abstract↗
PubMed2002

Lack of manipulation of Rhodnius prolixus (Hemiptera: Reduviidae) vector competence by Trypanosoma cruzi.

Behavioral implications of Trypanosoma cruzi Chagas infection in Rhodnius prolixus Stål were observed. Feeding and defecation behaviors of infected versus uninfected insects were assessed on an artificial membrane-feeding system and on live guinea pigs. Based on a defecation index, fifth instars were the most efficient vectors, followed by adult females, fourth instars, and adult males. Bugs fasted for longer periods (5-6 mo) took smaller blood meals but defecated significantly earlier than bugs fasted for shorter periods (2-3 mo). Multiple blood feeding, degree of fasting, life stage, T cruzi infection, and gender affected the vector potential of R. prolixus. Our data indicate that T. cruzi and R. prolixus have not coevolved to facilitate the transmission of T. cruzi, which suggests that this parasite-host relationship may be relatively recent.

Animals↗
PubMedDate not supplied

Spatial and time distribution of dairy cattle excreta in an intensive pasture system.

This study determined distribution of feces and urine from 36 lactating dairy cattle (Bos taurus) managed in a rotationally grazed 0.74-ha endophyte-free tall fescue (Festuca arundinacea Schreb.)-white clover (Trifolium repens L.) pasture. Cows were observed for 24 h five times from July 1997 to April 1998, and for 13.5 h in September 1997. During each 24-h observation period, the first grazing period (12 h) used 54% of the paddock and the second grazing period (8 h) used the entire paddock. Times and locations of all defecations and urinations from a subgroup of eight cows, observed while in the pasture, feed area, milking parlor, or in transit were recorded during the observation periods listed above and another time in May 1997. On pasture, all defecations and urinations were surveyed and mapped for all 36 cows. Feces and urine from six observation periods covered an estimated 10% of the paddock area in one year. Within 30 m of the water tank, concentrations of feces and urine from three warm-season observations were significantly greater than concentrations during three cool-season observations. Percentages of defecations and urinations on the pasture, feeding, and milking areas were highly correlated (r > 0.90) with time spent in those areas. Pasture-based systems could reduce manure handling and storage requirements proportional to the time cattle are on pastures. Manure on the pasture was evenly distributed, except around the water tank during warm-weather grazings. Results indicate that pasture-based dairy systems may require smaller, less-expensive manure management systems compared with confinement dairy farms.

Agriculture↗
PubMedDate not supplied

Influence of hygiene on gastrointestinal illness among wilderness backpackers.

BACKGROUND: Gastrointestinal illness is a common risk for wilderness travelers, even among those who consistently disinfect their water, yet the importance of hygiene has not been characterized. METHODS: In a prospective surveillance study, 334 Appalachian Trail backpackers who hiked for at least 7 days in 1997 were interviewed. Upon completion of their hike, a written questionnaire was sent, addressing illnesses, water disinfection methods, and hygiene. Hygiene inquiries focused on the frequency of behaviors concerning handwashing and cleaning cookware. RESULTS: Two hundred and eighty backpackers compiled 38,940 wilderness exposure days, with 56% (n=56) experiencing diarrhea. Diarrhea correlated with the frequency of drinking untreated surface water (relative risk (RR) 2.4, 95% confidence interval (CI) 1.0-4.7%, p5.03). Of those who consistently treated water, 45% suffered from diarrhea, whereas 69% of those who inconsistently treated water experienced diarrhea (RR 0.65, 95% CI 0.53-0.81%, p5.001). Hikers practicing "good hygiene", defined as handwashing post-defecation and cleaning cookware routinely, were less likely to ever experience diarrhea (RR 0.47, 95% CI 0.22-0.99, p5.04). Routine handwashing with soap and water after both urination and defecation reduced the risk of diarrhea (RR 0.11, 95% CI 0.04-0.31%, p,.001). In a case-control analysis of those experiencing diarrhea, decreased diarrhea was associated with routine consumption of multivitamins (RR 0.50, 95% CI 0.37-0.66%, p,.001), routine cleaning of utensils with warm, soapy water (RR 0.38, 95% CI 0.20-0.74%, p,.01), and post-defecation handwashing with soap and water (RR 0.61, 95% CI 0.39-0.93%, p5.006). CONCLUSIONS: Lack of hygiene, specifically handwashing and cleaning of cookware, should be recognized as a significant contributor to wilderness gastrointestinal illness. Hikers should routinely disinfect water and avoid untreated surface water.

Adult↗
PubMed1980

Toxoplasma gondii in Costa Rican cats.

Toxoplasma gondii infection of cats was studied in seven localities in Costa Rica. A total of 237 cats were tested for antibody by the dye test, and for oocysts by injection into mice. Toxoplasma was isolated from 55 (23%) and antibody was found in 109 (46%). Sixty percent of cats were infected as shown by shedding or antibody. Of the 55 isolations, 64% were from kittens without antibody and 36% from kittens with antibody. Almost half of the Toxoplasma isolations were made from the feces of kittens weighing less than 600 g, 35 cm in length, or under 2 months of age, of which 41% were shedding Toxoplasma. Six hundred and seventy-six homeowners in the seven towns were questioned about the number of owned and stray cats visiting their houses, the cats' pattern of roaming, food sources, types of food foraged, defecation sites outdoors and indoors, and location of fecal deposits in houses. Seventy-six percent of houses reported cats, which averaged 2.1 cats per house; about 80% were strays, and 99% lived outdoors part or all of the time. The cats visited from 5-12 (average 6) houses, foraging for food in garbage, hunting mice, rats, sparrows and insects. Of the 516 households reporting cats, 29% supplied some food in addition. In 14% of these houses cats defecated in the house, including the false attic and crawl space; they commonly defecated in front and backyards of houses, close to human habitation and accessible to intermediate hosts.

Animals↗
PubMed2000

[Short- and long-term results of sphincter preserving operations with creation of colonic J-reservoir].

The aim of this study was to evaluate short- and long-term results of sphincter preserving operations with forming a colonic J-reservoir. This study examined the results of the treatment of 63 patients with medioampullary carcinoma of the rectum. Sphincter preserving operations with forming a reservoiroanal anastomosis were made in 34 patients (test group), 29 patients had sphincter preserving operations with forming coloanal and supraanal colorectal anastomoses (control group). In the test group complications were observed in 6 (17.6%) patients and in the control group in 6 (20.7%) patients (p = 0.3962). The defecation frequency in the test group 3 months after the operation was 1.87 +/- (1-3) time a day, in the control group even through 12 months--3.0 +/- 1.5 times a day (p = 0.0001). In terms up to 6 months tenesmus, imperative desire to defecate and defecation's multistage more often disturbed the patients of the control group (p = 0.0005). The function of the faeces continence was satisfactory in both the patients' groups, however in the control group the events of the anal incontinence of I-II degree (p > 0.05) occurred more often. The negative aspect of the colonic reservoir's forming is frequent change of the evacuation function with constipation, however, the differences were statistically insignificant (p > 0.05). Creation of a colonic reservoir doesn't increase lethality and postoperative complications rate, allows to reduce clinical manifestations of a "low anterior resection" syndrome.

Adult↗
PubMed2003

[Long-term follow-up after complete treatment of peritoneal endometriosis with the CO2 laser].

OBJECTIVE: To evaluate the effect of laparoscopic CO2 laser ablation of peritoneal endometriosis in the treatment of pelvic pain with a long-term follow-up. To differentiate the effect of surgery on different types of pelvic pain. DESIGN: Prospective observational study. SETTING: Department of Obstetrics and Gynecology, 1st Medical Faculty, Charles University and General Faculty Hospital, Prague. METHODS: Patients with 1st to 3rd stage endometriosis, with manifestation of pelvic pain, and with complete excision of peritoneal endometriosis lesions, were included in the study. All visible lesions were vaporized by CO2 laser following adhesiolysis and complete visualization of the pelvis. After the procedure, patients were followed up at 6-month intervals. The severity of pelipathia, dyspareunia, dysmenorrhea, pain during micturition, and pain during defecation were monitored using a visual analog score of 10 points. RESULTS: A total of 31 patients were included in the study. After 6, 12, and 18 months after surgery, the recurrence of pelvic pain was found in 12 (39%), 15 (48%), and 19 (61%) patients, respectively. Improvement or disappearance of complaints was documented 18 months after the surgery in 11 cases of dysmenorrhea (50%), 9 cases of dyspareunia (50%), 14 cases of pelipathia (58%), 12 cases of pain during micturition (71%), and in 14 cases of pain during defecation (87.5%). The proportion of recurrences increases with the length of the interval after the procedure, mainly in dysmenorrhea and dyspareunia. CONCLUSIONS: The effect (improvement or disappearance of pelvic pain) of a complete CO2 laser ablation of peritoneal endometriosis continues 18 months after the surgery in about 40% of patients. A graduated increase in the number of recurrences is apparent during follow-up, most significantly in dysmenorrhea and dyspareunia. The effect of surgery on different types of pelvic pain varies. A small number of recurrences was found in pain during micturition and pain during defecation, on the other hand, less success was apparent in the treatment of dysmenorrhea.

Adult↗
PubMed2004

Manometric tests of anorectal function in healthy adult Thai subjects.

BACKGROUND AND OBJECTIVES: Diseases of the distal gastrointestinal tract are becoming more common among Thai people especially in the elderly. Manometry is a new and useful technique in the diagnosis and management of anorectal disorders. This cross-sectional study aimed to measure anorectal manometric parameters in normal Thai subjects. MATERIAL AND METHOD: Thirty healthy Thai subjects (17 males and 13 females) were studied. They completed a questionnaire assessing their bowel function. A water-perfused manometric system with non-pull-through technique was used to monitor pressure in the rectum and anus. All subjects were asked to squeeze the anal sphincters, bear down, then blow up a party balloon. Rectal sensation and recto-anal inhibitory reflex were also assessed by intermittent phasic balloon distention. Simulated defecation or balloon expulsion test was also performed. RESULT: The study revealed the following anorectal manometric parameters. The mean with standard deviation of the resting, squeezed, and sustained squeezed pressures were 55.4 +/- 15.3, 170.3 +/- 81.7 and 109.3 +/- 54.4 mm Hg respectively. Men had a longer anal sphincter (p = 0.01) and higher squeezed, and sustained squeezed pressures (p < 0. 001) compared to women, while their resting sphincter pressures were similar. Threshold volumes for rectal sensation and desire to defecate were not different among male and female subjects, but the threshold for urgency to defecate was higher in men. The study yielded normal anorectal manometric parameters in Thai subjects. Some parameters vary with gender. It is difficult to compare these normal ranges in Thai subjects to those in Caucasians, as the number of subjects is rather small and the details of instruments and techniques always vary from lab to lab. The manometric findings in these Thai subjects create more understanding in anorectal physiology and can be used as a guideline for the investigation of anorectal function in a symptomatic Thai population in a motility clinic.

Adolescent↗