An assessment of anorectal motility in the management of adult megacolon.

Anorectal motility measurements have been performed on 19 patients with adult megacolon and the results compared with 12 normal subjects. Adult Hirschsprung's disease (4 patients) was recognized by the absence of anal canal inhibition on rectal distension (normal mean inhibition 21.9 +/- 2.3 mmHg). Seven patients with non-Hirschsprung's megacolon (idiopathic) had an elevated anal pressure (mean 90.4 +/- 7.0 mmHg). These patients were treated with repeated anal dilatation. Eight further patients had normal anal canal pressures (mean 33.2 +/- 11.7 mmHg) and were treated with enemas and regular suppositories. Little overall clinical improvement resulted in this group and 1 patient underwent subtotal colectomy. Measurements of anorectal motility have been found to assist in the management of adult megacolon.