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Evacuation proctography in normal volunteers
M G Freimanis1, A Wald, B Caruana
1Department of Radiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612.
Investigative Radiology
|June 1, 1991
Summary
Defecography findings in constipation patients are often misinterpreted. Many asymptomatic individuals exhibit "abnormal" results, highlighting the need for cautious interpretation of defecography in clinical decision-making.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Radiology
Background:
- Evacuation proctography (defecography) is used to evaluate constipation.
- Abnormal findings can lead to aggressive medical or surgical treatment.
- Normal defecography criteria and symptom correlation are not well-established.
Purpose of the Study:
- To assess defecography findings in asymptomatic volunteers.
- To establish quantitative measures of normal rectal emptying.
- To evaluate the correlation between radiographic findings and evacuation efficiency.
Main Methods:
- Prospective study of 21 asymptomatic volunteers.
- Standard defecography technique using barium paste.
- Analysis of rectocele, intussusception, pelvic descent, and puborectalis spasm.
- Quantification of rectal emptying percentage.
Main Results:
- 67% of volunteers (14/21) showed "abnormal" findings (rectocele, intussusception, etc.).
- Rectal emptying ranged from 12.5% to 100%.
- 19% of volunteers (4/21) evacuated <= 40% of barium paste.
- No correlation found between radiographic abnormality severity and evacuation degree.
Conclusions:
- Defecography findings vary widely in asymptomatic individuals.
- Radiographic abnormalities are common in healthy subjects.
- Defecography results require cautious interpretation for patients undergoing intervention.