Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania "L. Vanvitelli", via Pansini, 5, 80100 Naples, Italy.
Division of General, Mininvasive and Bariatric Surgery, University of Campania \'Luigi Vanvitelli\', Via Pansini 5, 80100, Naples, Italy.
Rev Recent Clin Trials. 2022;17(2):97-102. doi: 10.2174/1574887117666220513110705.
Ulcerative colitis may impair anorectal function, causing disabling symptoms such as incontinence and/or increase in the stool frequency, urgency and tenesmus. Data on anorectal function in these patients evaluated by conventional anorectal manometry are conflicting.
The aim of this prospective study was to assess by means of high resolution anorectal manometry the anorectal function in patients with mild-to-moderate ulcerative colitis at presentation and after remission. Anorectal function of ulcerative colitis patients was compared to that observed in healthy volunteers.
20 patients with mild to moderate left-sided ulcerative colitis or proctitis and 20 healthy volunteers were prospectively enrolled. All ulcerative colitis patients underwent high resolution anorectal manometry before treatment and after clinical remission.
Ulcerative colitis patients showed similar values for anal sphincter function as healthy volunteers, whereas rectal threshold volume for the first sensation, desire to defecate, urgency to defecate and maximum discomfort were significantly lower than in healthy volunteers (p<0.05). Rectal compliance was significantly lower in ulcerative colitis than in healthy volunteers (p<0.05). After remission, rectal threshold volumes, as well as rectal compliance, significantly increased. An inverse linear correlation was found between regression of urgency and stool frequency and rectal compliance (r=0.811; p<0.05).
Ulcerative colitis patients show altered rectal function, with increased rectal sensitivity and lower compliance, compared to controls. This altered function is restored after successful treatment of the underlying inflammatory process. Finally high resolution anorectal manometry provides useful information on anorectal functionality and, in our opinion, should be preferred over conventional manometry.
溃疡性结肠炎可能会损害肛肠功能，导致失禁和/或粪便频率、紧迫性和直肠紧迫感增加等致残症状。通过传统肛肠测压评估这些患者肛肠功能的数据存在争议。
本前瞻性研究旨在通过高分辨率肛肠测压评估初诊和缓解后轻度至中度溃疡性结肠炎患者的肛肠功能。将溃疡性结肠炎患者的肛肠功能与健康志愿者进行比较。
前瞻性纳入 20 例左半结肠炎或直肠炎轻中度溃疡性结肠炎患者和 20 例健康志愿者。所有溃疡性结肠炎患者在治疗前和临床缓解后均行高分辨率肛肠测压。
溃疡性结肠炎患者的肛门括约肌功能与健康志愿者相似，而首次感觉、排便欲望、排便紧迫性和最大不适的直肠阈值容积明显低于健康志愿者（p<0.05）。直肠顺应性也显著低于健康志愿者（p<0.05）。缓解后，直肠阈值容积和直肠顺应性均显著增加。排便急迫性和粪便频率与直肠顺应性呈负相关（r=0.811；p<0.05）。
与对照组相比，溃疡性结肠炎患者的直肠功能发生改变，直肠敏感性增加，顺应性降低。在成功治疗潜在炎症过程后，这种改变的功能得到恢复。最后，高分辨率肛肠测压提供了有关肛肠功能的有用信息，我们认为，它应优于传统测压。
