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At least 1,063 records · Page 59Linked to original sources
PubMed1989

Anorectal manometry after Ikeda's Z-shaped anastomosis in Hirschsprung's disease.

The intraluminal pressure of the rectum and anal canal were measured in patients with Hirschsprung's disease before and after Ikeda's Z-shaped anastomosis, and the association of the pressure with postoperative capability of fecal continence was assessed. Radical operation did not alter rectal pressure but did decrease anal-canal pressure. Rhythmical anal contractions increased in frequency until a normal level was attained. The rectoanal relaxation reflex became distinct with time, and 45% of patients eventually attained the reflex after operation. In patients who postoperatively attained satisfactory fecal continence or, at least, only soiling, resting pressure in the anorectum and the frequency of rhythmical anal-canal contractions were similar to those for normal children. The rectoanal relaxation reflex was induced in 58% of the former and 27% of the latter. In patients with postoperative constipation, the intraluminal resting pressure of the anorectum was elevated without the relaxation reflex response. In patients with incontinence, the pressure of the anal canal was low, without a reflex response. These findings indicate that the high and low values of the resting pressure of the anal canal are responsible for constipation and incontinence, respectively, and that the presence of rectoanal relaxation reflex may represent one aspect of a normal defecation function.

Anal Canal↗
PubMed1989

[Comparative study on various methods currently used in anal manometry].

We compared the measurements obtained with different systems presently used to study the pressure characteristics of the anal channel (an open perfusion probe, a closed perfusion probe and a microtransducer). We also studied rectal sensitivity to distention in an attempt to define the exactness and reliability of the measurements made with these different techniques. The results indicate that although the measurements obtained vary with the diameter of the catheters used, the differences were not statistically significant. In contrast, the maximum tolerated volume of patients is greater with a slow and continuous rhythm of infusion than when saline is infused rapidly and in boluses. The published literature is reviewed and results are discussed, as well as the advantages and disadvantages of different methods.

Adult↗
PubMed1989

Anorectal manometry in active and quiescent ulcerative colitis.

Anorectal function was measured in 11 patients with active medically intractable ulcerative colitis, seven patients with quiescent ulcerative colitis, and 18 healthy subjects. The anal resting pressure, squeeze pressure, and ability to defecate a balloon were similar in all groups. Significantly lower rectal distention volumes were required for rectal sensation, critical volume, and to induce rectal contractility in patients with active disease compared to controls or patients with quiescent disease. Rectal compliance was significantly reduced in patients with active and quiescent disease. The increased rectal sensitivity and contractility in patients with active colitis appear to be related to active mucosal inflammation and ulceration. Episodes of mucosal inflammation may be responsible for chronic changes in the rectal wall resulting in fibrosis and decreased compliance in patients with quiescent disease. The frequency and urgency of defecation and the fecal incontinence may be due to a hypersensitive, hyperactive, and poorly compliant rectum.

Adult↗