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The longitudinal high-pressure zone profile in patients with fecal incontinence
A Osterberg1, W Graf, L Påhlman
1Department of Surgery, University Hospital, Uppsala, Sweden.
Objective:
The aim of this study was to evaluate differences in the longitudinal high-pressure zone (HPZ) profile between incontinent patients and healthy controls.
Methods:
One hundred and fifty-six patients with fecal incontinence (mean age 63 yr; 139 women, 17 men) and 25 healthy controls (mean age 54 yr; 20 women, five men) underwent anorectal manometry with a perfused catheter using a station pull-through technique.
Results:
Maximum resting pressure (MRP) and maximum squeeze pressure (MSP) were lower in patients (p < 0.001) and the HPZ was shorter in patients (p < 0.05). The ratio MRP/sum of resting pressures within HPZ did not differ between the groups. The severity of incontinence measured as an incontinence score was correlated to MSP (p < 0.05) and sum of squeeze pressure within HPZ (p < 0.05), but not to any other variable. The relative pressure amount during rest in the distal half of HPZ was higher in controls (63% vs 56%, p < 0.05), but this was not seen during squeeze.
Conclusions:
These results suggest that the main difference between incontinent patients and healthy controls is a greater magnitude of the pressure profile in the latter group. Furthermore, the relative pressure accumulation during rest tended to be more distally located within the HPZ.