Brochard C, Siproudhis L, Ropert A, Mallak A, Bretagne J-F, Bouguen G
Service des Maladies de l'Appareil Digestif, CHU Pontchaillou, Université de Rennes 1, Rennes, France.
Services d'Explorations Fonctionnelles Digestives, CHU Pontchaillou, Université de Rennes 1, Rennes, France.
Neurogastroenterol Motil. 2015 Jul;27(7):1032-7. doi: 10.1111/nmo.12580. Epub 2015 May 4.
Rectal disorders during ulcerative colitis (UC) drastically alter the quality of life and may result from an impairment of rectal perception and compliance. This study aims to assess anorectal disorders in patients with mild-to-moderate UC.
Anal pressures and the rectal responses to phasic rectal isobaric distension in 10 patients with mild-to-moderate UC were prospectively compared with those in 10 healthy volunteers (HVs).
The patients in each group were similar regarding age, gender, and delivery. In the resting state, the anal canal pressures were similar between the groups. Only the squeeze pressures of the lower anal canal were significantly lower in UC patients than in HVs. During phasic isobaric distension, rectal sensitivity was similar between the groups, whatever the step of distension. Isobaric rectal distension resulted in a significant decrease of the rectoanal inhibitory reflex and a decrease in rectal tone and a significant drop in rectal compliance in UC patients compared with HVs.
CONCLUSIONS & INFERENCES: Patients showing mild-to-moderate UC experience rectal compliance and innervation disorders without a significant change in rectal sensitivity. The findings of this work suggest impairment not only of the properties of the rectal wall but also of intrinsic innervation. Repeated evaluation over time may be helpful for analyzing the reversibility of the process after healing.
溃疡性结肠炎（UC）期间的直肠疾病会极大地改变生活质量，可能是由于直肠感知和顺应性受损所致。本研究旨在评估轻至中度UC患者的肛肠疾病。
前瞻性比较10例轻至中度UC患者与10名健康志愿者（HV）的肛管压力及直肠对阶段性直肠等压扩张的反应。
每组患者在年龄、性别和分娩情况方面相似。在静息状态下，两组之间的肛管压力相似。仅UC患者的低位肛管挤压压力显著低于HV。在阶段性等压扩张期间，无论扩张程度如何，两组之间的直肠敏感性相似。与HV相比，等压直肠扩张导致UC患者的直肠肛管抑制反射显著降低、直肠张力降低以及直肠顺应性显著下降。
轻至中度UC患者存在直肠顺应性和神经支配障碍，但直肠敏感性无显著变化。这项工作的结果表明不仅直肠壁特性受损，内在神经支配也受损。随着时间的推移进行重复评估可能有助于分析愈合后该过程的可逆性。
