Rectal hyposensitivity prevalence and clinical impact in patients with intractable constipation and fecal incontinence
Blunted rectal sensation, or rectal hyposensitivity, has been reported anecdotally in patients with functional disorders of evacuation and continence. The purpose of this study was to determine the prevalence of rectal hyposensitivity and whether the finding of such an abnormality was associated wit...
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| Veröffentlicht in: | Diseases of the colon & rectum 2003-02, Vol.46 (2), p.238-246 |
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| creator | GLADMAN, Marc A SCOTT, S. Mark CHAN, Christopher L. H WILLIAMS, Norman S LUNNISS, Peter J |
| description | Blunted rectal sensation, or rectal hyposensitivity, has been reported anecdotally in patients with functional disorders of evacuation and continence. The purpose of this study was to determine the prevalence of rectal hyposensitivity and whether the finding of such an abnormality was associated with any clinical impact.
One thousand three hundred fifty-one patients, referred for anorectal physiologic investigation, were divided according to presenting symptoms into the following categories: constipation (subdivided into infrequency of and/or obstructed defecation), fecal incontinence (subdivided into passive, postdefecation, and urge incontinence), fecal incontinence and constipation, or "other." Rectal hyposensitivity was judged to be present when at least one of the sensory threshold volumes was elevated beyond the normal range (mean plus 2 standard deviations). The prevalence of rectal hyposensitivity was then calculated in each group and in relation to other investigations.
Rectal hyposensitivity was present in 16 percent of patients, with males and females equally affected. Twenty-three percent of patients with constipation, 10 percent of patients with fecal incontinence, 27 percent of patients with incontinence associated with constipation, and only 5 percent of patients with other symptoms were found to have rectal hyposensitivity. In patients with obstructed defecation, rectal hyposensitivity was present in 33 percent with rectocele, 40 percent with intussusception, and 53 percent with no mechanical obstruction evident on evacuation proctography.
Rectal hyposensitivity is common in patients with constipation and/or fecal incontinence and may thus be important in the etiology of such conditions. Although the clinical relevance of this physiologic abnormality is unknown, its presence may have implications regarding the management of hindgut dysfunction and particularly the selection of patients for surgery. |
| doi_str_mv | 10.1007/s10350-004-6529-x |
| format | Article |
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One thousand three hundred fifty-one patients, referred for anorectal physiologic investigation, were divided according to presenting symptoms into the following categories: constipation (subdivided into infrequency of and/or obstructed defecation), fecal incontinence (subdivided into passive, postdefecation, and urge incontinence), fecal incontinence and constipation, or "other." Rectal hyposensitivity was judged to be present when at least one of the sensory threshold volumes was elevated beyond the normal range (mean plus 2 standard deviations). The prevalence of rectal hyposensitivity was then calculated in each group and in relation to other investigations.
Rectal hyposensitivity was present in 16 percent of patients, with males and females equally affected. Twenty-three percent of patients with constipation, 10 percent of patients with fecal incontinence, 27 percent of patients with incontinence associated with constipation, and only 5 percent of patients with other symptoms were found to have rectal hyposensitivity. In patients with obstructed defecation, rectal hyposensitivity was present in 33 percent with rectocele, 40 percent with intussusception, and 53 percent with no mechanical obstruction evident on evacuation proctography.
Rectal hyposensitivity is common in patients with constipation and/or fecal incontinence and may thus be important in the etiology of such conditions. Although the clinical relevance of this physiologic abnormality is unknown, its presence may have implications regarding the management of hindgut dysfunction and particularly the selection of patients for surgery.</description><identifier>ISSN: 0012-3706</identifier><identifier>EISSN: 1530-0358</identifier><identifier>DOI: 10.1007/s10350-004-6529-x</identifier><identifier>PMID: 12576898</identifier><identifier>CODEN: DICRAG</identifier><language>eng</language><publisher>Secaucus, NJ: Springer</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Constipation - complications ; Constipation - epidemiology ; Diagnostic Techniques, Digestive System ; Fecal Incontinence - complications ; Fecal Incontinence - epidemiology ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Hypesthesia - diagnosis ; Hypesthesia - epidemiology ; Hypesthesia - etiology ; Male ; Manometry - methods ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Prevalence ; Rectal Diseases - diagnosis ; Rectal Diseases - epidemiology ; Rectal Diseases - etiology ; Sensory Thresholds - physiology ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><ispartof>Diseases of the colon & rectum, 2003-02, Vol.46 (2), p.238-246</ispartof><rights>2003 INIST-CNRS</rights><rights>The American Society of Colon and Rectal Surgeons 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,780,784,789,790,23930,23931,25140,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14552558$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12576898$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GLADMAN, Marc A</creatorcontrib><creatorcontrib>SCOTT, S. Mark</creatorcontrib><creatorcontrib>CHAN, Christopher L. H</creatorcontrib><creatorcontrib>WILLIAMS, Norman S</creatorcontrib><creatorcontrib>LUNNISS, Peter J</creatorcontrib><title>Rectal hyposensitivity prevalence and clinical impact in patients with intractable constipation and fecal incontinence</title><title>Diseases of the colon & rectum</title><addtitle>Dis Colon Rectum</addtitle><description>Blunted rectal sensation, or rectal hyposensitivity, has been reported anecdotally in patients with functional disorders of evacuation and continence. The purpose of this study was to determine the prevalence of rectal hyposensitivity and whether the finding of such an abnormality was associated with any clinical impact.
One thousand three hundred fifty-one patients, referred for anorectal physiologic investigation, were divided according to presenting symptoms into the following categories: constipation (subdivided into infrequency of and/or obstructed defecation), fecal incontinence (subdivided into passive, postdefecation, and urge incontinence), fecal incontinence and constipation, or "other." Rectal hyposensitivity was judged to be present when at least one of the sensory threshold volumes was elevated beyond the normal range (mean plus 2 standard deviations). The prevalence of rectal hyposensitivity was then calculated in each group and in relation to other investigations.
Rectal hyposensitivity was present in 16 percent of patients, with males and females equally affected. Twenty-three percent of patients with constipation, 10 percent of patients with fecal incontinence, 27 percent of patients with incontinence associated with constipation, and only 5 percent of patients with other symptoms were found to have rectal hyposensitivity. In patients with obstructed defecation, rectal hyposensitivity was present in 33 percent with rectocele, 40 percent with intussusception, and 53 percent with no mechanical obstruction evident on evacuation proctography.
Rectal hyposensitivity is common in patients with constipation and/or fecal incontinence and may thus be important in the etiology of such conditions. Although the clinical relevance of this physiologic abnormality is unknown, its presence may have implications regarding the management of hindgut dysfunction and particularly the selection of patients for surgery.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Constipation - complications</subject><subject>Constipation - epidemiology</subject><subject>Diagnostic Techniques, Digestive System</subject><subject>Fecal Incontinence - complications</subject><subject>Fecal Incontinence - epidemiology</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Hypesthesia - diagnosis</subject><subject>Hypesthesia - epidemiology</subject><subject>Hypesthesia - etiology</subject><subject>Male</subject><subject>Manometry - methods</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Prevalence</subject><subject>Rectal Diseases - diagnosis</subject><subject>Rectal Diseases - epidemiology</subject><subject>Rectal Diseases - etiology</subject><subject>Sensory Thresholds - physiology</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><issn>0012-3706</issn><issn>1530-0358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU9rGzEQxUVoiJ0_H6CXshTS26YjaUe7PhbTNAVDIKRnIWtnicxau5VkN_720caGQA9CaOb3nkZ6jH3mcMcB6u-Rg0QoAapSoViUr2dszlHmisTmE5sDcFHKGtSMXca4yUcQUF-wGRdYq2bRzNn-iWwyffFyGIdIPrrk9i4dijHQ3vTkLRXGt4XtnXc2c247GpsK54vRJEc-xeKfSy-5kEJumHVPhR18TG7qD_5d3dG71OdGcn4yvWbnnekj3Zz2K_bn_ufz8qFcPf76vfyxKq0ElUqTn9YicUQjAKTgFaoFXyABWkGVEqJer01Hla2aBltr0bayJSGFkSAaIa_Yt6PvGIa_O4pJb1201PfG07CLus7YtDL49T9wM-yCz7PpfCsorkBliB8hG4YYA3V6DG5rwkFz0FMi-piIzmPrKRH9mjVfTsa79ZbaD8UpggzcngAT8zd1wXjr4gdXIQrERr4BiP2VOg</recordid><startdate>20030201</startdate><enddate>20030201</enddate><creator>GLADMAN, Marc A</creator><creator>SCOTT, S. Mark</creator><creator>CHAN, Christopher L. H</creator><creator>WILLIAMS, Norman S</creator><creator>LUNNISS, Peter J</creator><general>Springer</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20030201</creationdate><title>Rectal hyposensitivity prevalence and clinical impact in patients with intractable constipation and fecal incontinence</title><author>GLADMAN, Marc A ; SCOTT, S. Mark ; CHAN, Christopher L. H ; WILLIAMS, Norman S ; LUNNISS, Peter J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c306t-a004d5e155a2003214569195e05c2e46227bbafe4c4885dcc5cd3de232a302823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Constipation - complications</topic><topic>Constipation - epidemiology</topic><topic>Diagnostic Techniques, Digestive System</topic><topic>Fecal Incontinence - complications</topic><topic>Fecal Incontinence - epidemiology</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Hypesthesia - diagnosis</topic><topic>Hypesthesia - epidemiology</topic><topic>Hypesthesia - etiology</topic><topic>Male</topic><topic>Manometry - methods</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Prevalence</topic><topic>Rectal Diseases - diagnosis</topic><topic>Rectal Diseases - epidemiology</topic><topic>Rectal Diseases - etiology</topic><topic>Sensory Thresholds - physiology</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GLADMAN, Marc A</creatorcontrib><creatorcontrib>SCOTT, S. Mark</creatorcontrib><creatorcontrib>CHAN, Christopher L. H</creatorcontrib><creatorcontrib>WILLIAMS, Norman S</creatorcontrib><creatorcontrib>LUNNISS, Peter J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Diseases of the colon & rectum</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GLADMAN, Marc A</au><au>SCOTT, S. Mark</au><au>CHAN, Christopher L. H</au><au>WILLIAMS, Norman S</au><au>LUNNISS, Peter J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rectal hyposensitivity prevalence and clinical impact in patients with intractable constipation and fecal incontinence</atitle><jtitle>Diseases of the colon & rectum</jtitle><addtitle>Dis Colon Rectum</addtitle><date>2003-02-01</date><risdate>2003</risdate><volume>46</volume><issue>2</issue><spage>238</spage><epage>246</epage><pages>238-246</pages><issn>0012-3706</issn><eissn>1530-0358</eissn><coden>DICRAG</coden><abstract>Blunted rectal sensation, or rectal hyposensitivity, has been reported anecdotally in patients with functional disorders of evacuation and continence. The purpose of this study was to determine the prevalence of rectal hyposensitivity and whether the finding of such an abnormality was associated with any clinical impact.
One thousand three hundred fifty-one patients, referred for anorectal physiologic investigation, were divided according to presenting symptoms into the following categories: constipation (subdivided into infrequency of and/or obstructed defecation), fecal incontinence (subdivided into passive, postdefecation, and urge incontinence), fecal incontinence and constipation, or "other." Rectal hyposensitivity was judged to be present when at least one of the sensory threshold volumes was elevated beyond the normal range (mean plus 2 standard deviations). The prevalence of rectal hyposensitivity was then calculated in each group and in relation to other investigations.
Rectal hyposensitivity was present in 16 percent of patients, with males and females equally affected. Twenty-three percent of patients with constipation, 10 percent of patients with fecal incontinence, 27 percent of patients with incontinence associated with constipation, and only 5 percent of patients with other symptoms were found to have rectal hyposensitivity. In patients with obstructed defecation, rectal hyposensitivity was present in 33 percent with rectocele, 40 percent with intussusception, and 53 percent with no mechanical obstruction evident on evacuation proctography.
Rectal hyposensitivity is common in patients with constipation and/or fecal incontinence and may thus be important in the etiology of such conditions. Although the clinical relevance of this physiologic abnormality is unknown, its presence may have implications regarding the management of hindgut dysfunction and particularly the selection of patients for surgery.</abstract><cop>Secaucus, NJ</cop><pub>Springer</pub><pmid>12576898</pmid><doi>10.1007/s10350-004-6529-x</doi><tpages>9</tpages></addata></record> |
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| subjects | Adolescent Adult Biological and medical sciences Constipation - complications Constipation - epidemiology Diagnostic Techniques, Digestive System Fecal Incontinence - complications Fecal Incontinence - epidemiology Female Gastroenterology. Liver. Pancreas. Abdomen Humans Hypesthesia - diagnosis Hypesthesia - epidemiology Hypesthesia - etiology Male Manometry - methods Medical sciences Middle Aged Other diseases. Semiology Prevalence Rectal Diseases - diagnosis Rectal Diseases - epidemiology Rectal Diseases - etiology Sensory Thresholds - physiology Stomach. Duodenum. Small intestine. Colon. Rectum. Anus |
| title | Rectal hyposensitivity prevalence and clinical impact in patients with intractable constipation and fecal incontinence |
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