Anorectal function: defecographic measurement in asymptomatic subjects

Area of Science:

• Gastroenterology
• Pelvic Floor Disorders
• Diagnostic Imaging

Background:

• Anorectal function assessment is crucial for diagnosing pelvic floor disorders.
• Fluoroscopically monitored defecation (defecography) is a key imaging technique.
• Understanding variations in asymptomatic individuals is essential for accurate interpretation.

Purpose of the Study:

• To evaluate anorectal function during defecation in asymptomatic subjects using fluoroscopy.
• To assess the range of measurements and interobserver variability in defecographic parameters.
• To determine the clinical significance of observed anatomical changes.

Main Methods:

• 32 asymptomatic subjects underwent fluoroscopically monitored defecation.
• Independent observers measured anorectal angle, anorectal junction position, perineal motility, and anal canal width.
• Video recordings were reviewed during squeezing, rest, and straining phases.

Main Results:

• Significant interobserver variation was noted in most measured parameters.
• Incomplete rectal emptying was agreed upon in 17 subjects.
• Rectal wall changes (intussusception, rectocele, prolapse) were noted in 10 subjects.

Conclusions:

• Defecographic measurements show considerable variability and should be interpreted cautiously.
• Anatomical changes during defecation do not always correlate with symptoms.
• Defecography is valuable for detecting anorectal abnormalities, even in asymptomatic individuals.