Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, No. 59, Liuting Street, Zhejiang Province, Ningbo, 315010, China.
Ningbo Key Laboratory of Translational Medicine Research On Gastroenterology and Hepatology, No. 59, Liuting Street, Zhejiang Province, Ningbo, 315010, China.
Int J Colorectal Dis. 2024 Jul 16;39(1):110. doi: 10.1007/s00384-024-04680-1.
Ulcerative colitis (UC) is an inflammatory bowel disease with an unclear etiology that can lead to irreversible changes in distal colonic function in chronic patients. This study investigated anorectal function in recurrent UC patients and identified influencing factors.
This prospective study enrolled 33 recurrent UC patients and 40 newly diagnosed patients from January 2019 to December 2022. Data collection included clinical records, scores, and anorectal function assessments. Regression analyses were used to identify factors impacting anorectal function.
Recurrent UC patients had higher baseline CRP and fecal calprotectin levels, increased anxiety and depression, and more severe fecal incontinence. They also had lower BMIs, serum Hb and albumin (ALB) levels, and Inflammatory Bowel Disease Questionnaire scores than did initial-onset UC patients. Multivariate linear regression analysis revealed that long disease duration (coef. - 0.376, P < 0.001) and high fecal calprotectin level (coef. - 0.656, P < 0.001) independently influenced the initial sensation threshold in recurrent UC patients. Additionally, high fecal calprotectin (coef. - 0.073, P = 0.013) and high Zung Self-Rating Anxiety Scale score (coef. - 0.489, P = 0.001) were identified as two independent determinants of the defecation volume threshold. For the defecation urgency threshold, the independent factors included high disease duration (coef. - 0.358, P = 0.017) and high fecal calprotectin level (coef. - 0.499, P = 0.001). Similarly, the sole independent factor identified for the maximum capacity threshold was high fecal calprotectin (coef. - 0.691, P = 0.001).
Recurrent UC patients had increased rectal sensitivity and compromised anorectal function, which significantly impacted quality of life. Proactively managing the disease, reducing UC relapses, and addressing anxiety are effective measures for improving anorectal function in these patients.
溃疡性结肠炎（UC）是一种病因不明的炎症性肠病，可导致慢性患者远端结肠功能发生不可逆转的变化。本研究旨在调查复发性 UC 患者的肛肠功能，并确定影响肛肠功能的因素。
本前瞻性研究纳入了 2019 年 1 月至 2022 年 12 月期间的 33 例复发性 UC 患者和 40 例初发性 UC 患者。数据收集包括临床记录、评分和肛肠功能评估。采用回归分析来确定影响肛肠功能的因素。
复发性 UC 患者的基线 CRP 和粪便钙卫蛋白水平较高，焦虑和抑郁评分较高，粪便失禁较严重。与初发性 UC 患者相比，他们的 BMI、血清 Hb 和白蛋白（ALB）水平以及炎症性肠病问卷评分较低。多变量线性回归分析显示，疾病病程长（系数-0.376，P<0.001）和粪便钙卫蛋白水平高（系数-0.656，P<0.001）是复发性 UC 患者初始感觉阈值的独立影响因素。此外，粪便钙卫蛋白高（系数-0.073，P=0.013）和 Zung 自评焦虑量表评分高（系数-0.489，P=0.001）是排便量阈值的两个独立决定因素。对于排便急迫阈值，独立因素包括疾病病程长（系数-0.358，P=0.017）和粪便钙卫蛋白水平高（系数-0.499，P=0.001）。同样，最大容量阈值的唯一独立因素是粪便钙卫蛋白高（系数-0.691，P=0.001）。
复发性 UC 患者直肠敏感性增加，肛肠功能受损，严重影响生活质量。积极治疗疾病、减少 UC 复发以及缓解焦虑是改善此类患者肛肠功能的有效措施。
