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Evidence from dynamic integrated proctography to redefine anismus.

J P Roberts1, N R Womack, R I Hallan

  • 1Surgical Unit, Royal London Hospital, UK.

The British Journal of Surgery
|November 1, 1992
PubMed
Summary
This summary is machine-generated.

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Anismus, characterized by puborectalis electromyogram (EMG) recruitment, is a significant factor in defective rectal evacuation. A comprehensive definition requires EMG, intrarectal pressure, and evacuation assessment.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Physiology

Background:

  • Defective rectal evacuation is a common cause of constipation.
  • The role of anismus in impaired defecation requires further elucidation.

Purpose of the Study:

  • To investigate the etiological role of anismus in defective rectal evacuation.
  • To define diagnostic criteria for anismus.

Main Methods:

  • Dynamic integrated proctography and electromyography (EMG) were used.
  • 20 controls and 71 constipated patients were evaluated.
  • Patients were categorized based on evacuation efficiency.

Main Results:

  • Anismus was significantly more prevalent in patients with poor rectal evacuation (P < 0.01).

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  • Inability to raise intrarectal pressure was also more common in this group (P < 0.001).
  • A combination of anismus and inadequate intrarectal pressure was observed in some patients.
  • Conclusions:

    • Anismus is a key contributor to defective rectal evacuation.
    • A definitive diagnosis of anismus requires assessment of EMG recruitment, intrarectal pressure, and evacuation.
    • EMG recruitment alone is insufficient for diagnosing anismus.