Jutras Gabrielle, Wahba George, Ayuso Eloise, Neshkova Elissaveta, Bouin Mickael
Centre Hospitalier Universitaire de l'Université de Montréal (CHUM), Montréal, Québec, Canada.
J Can Assoc Gastroenterol. 2021 Apr 23;4(5):235-241. doi: 10.1093/jcag/gwaa045. eCollection 2021 Oct.
High-resolution anorectal manometry (HRM) is widely used in the evaluation of anal incontinence and constipation, which become increasingly prevalent with age. However, the impact of age and comorbidities on physiological digestive parameters remains poorly understood. In this study, we aimed to evaluate the effect of age on anorectal function.
We conducted a retrospective study on patients at our digestive motility clinic between January 2016 and May 2019. All patients with a normal HRM were included. Clinical data and HRM parameters were collected in a database. Multivariate regression analyses were performed to evaluate the effects of age, sex, medical comorbidities and obstetric history on anorectal HRM parameters.
One hundred and forty-four patients were included (mean age: 53 ± 16 years, 72% females). The main indications for anorectal HRM were incontinence (44%), constipation (37%) and anorectal pain (9%). Age was significantly associated with higher maximum tolerable volume (β = +0.48 mL year, = 0.04) and higher rectal compliance (β = +0.04 mL year, = 0.01). Independently from age and medical comorbidities, female demonstrated significantly lower mean endurance squeeze pressure (β = -44.4 mmHg, < 0.001), maximal squeeze pressure (β = -62.3 mmHg; < 0.001), volume at first urge (β = -16.7 mL, = 0.02) and maximum tolerable volume (β = -16.1 mL, = 0.046). Vaginal birth was associated with lower tolerable maximum pressure (β = -39.4 mmHg, = 0.046).
Age and sex are independent factors which influence anorectal HRM parameters. These findings should be taken into consideration when interpreting anorectal HRM.
高分辨率肛门直肠测压法（HRM）广泛应用于肛门失禁和便秘的评估，而这两种疾病随着年龄增长愈发普遍。然而，年龄和合并症对生理消化参数的影响仍知之甚少。在本研究中，我们旨在评估年龄对肛门直肠功能的影响。
我们对2016年1月至2019年5月期间在我们消化动力门诊的患者进行了一项回顾性研究。纳入所有HRM正常的患者。临床数据和HRM参数收集于一个数据库中。进行多变量回归分析以评估年龄、性别、合并症和产科史对肛门直肠HRM参数的影响。
纳入144例患者（平均年龄：53±16岁，72%为女性）。肛门直肠HRM的主要指征为失禁（44%）、便秘（37%）和肛门直肠疼痛（9%）。年龄与更高的最大耐受容量（β = +0.48 mL/年，P = 0.04）和更高的直肠顺应性（β = +0.04 mL/年，P = 0.01）显著相关。独立于年龄和合并症之外，女性的平均持续挤压压力（β = -44.4 mmHg，P < 0.001）、最大挤压压力（β = -62.3 mmHg；P < 0.001）、首次便意时的容量（β = -16.7 mL，P = 0.02）和最大耐受容量（β = -16.1 mL，P = 0.046）显著更低。经阴道分娩与更低的最大耐受压力（β = -39.4 mmHg，P = 0.046）相关。
年龄和性别是影响肛门直肠HRM参数的独立因素。在解读肛门直肠HRM结果时应考虑这些发现。
