The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Rectal hyposensitivity and functional anorectal outlet obstruction are common entities in patients with functional constipation but are not significantly associated

  • Lee, Tae Hee (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Lee, Joon Seong (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Hong, Su Jin (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Jeon, Seong Ran (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Kwon, Soon Ha (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Kim, Wan Jung (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Kim, Hyun Gun (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Cho, Won Young (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Cho, Joo Young (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Kim, Jin-Oh (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Lee, Ji Sung (Division of Biostatistics, Graduate School of Public Health, Korea University)
  • Published : 2013.01.01
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Abstract

Background/Aims: The causes of functional anorectal outlet obstruction (outlet obstruction) include functional defecation disorder (FDD), rectocele, and rectal intussusception (RI). It is unclear whether outlet obstruction is associated with rectal hyposensitivity (RH) in patients with functional constipation (FC). The aim of this study was to determine the association between RH and outlet obstruction in patients with FC. Methods: This was a retrospective study using a prospectively collected constipation database, and the population comprised 107 patients with FC (100 females; median age, 49 years). We performed anorectal manometry, defecography, rectal barostat, and at least two tests (balloon expulsion test, electromyography, or colon transit time study). RH was defined as one or more sensory threshold pressures raised beyond the normal range on rectal barostat. We investigated the association between the presence of RH and an outlet obstruction such as large rectocele (> 2 cm in size), RI, or FDD. Results: Forty patients (37.4%) had RH. No significant difference was observed in RH between patients with small and large rectoceles (22 [44.9%] vs. 18 [31%], respectively; p = 0.140). No significant difference was observed in RH between the non-RI and RI groups (36 [36.7%] vs. 4 [30.8%], respectively; p = 0.599). Furthermore, no significant difference in RH was observed between the non-FDD and FDD groups (19 [35.8%] vs. 21 [38.9%], respectively; p = 0.745). Conclusions: RH and outlet obstruction are common entities but appear not to be significantly associated.

Keywords

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