Anorectal function in elderly patients with fecal impaction

Manometric and other investigations were carried out in 55 elderly patients who had impacted masses of feces in the rectum upon admission to hospital and in 36 elderly age- and sex-matched control subjects. Maximum basal and maximum squeeze sphincter pressures in the patients were similar to those in the elderly controls. Most elderly patients in the impacted group and all control subjects were able to pass a 50-ml balloon from the rectum, although a lower proportion of patients, admitted with impaction, could expel a small solid sphere. In patients the rectum had to be distended with larger volumes than in controls before the presence of the rectal balloon, pain, and the desire to defecate were perceived and before rectal contractions were generated. Rectal pressures, recorded during rectal distention, were lower in the impacted group than in the control group. Finally, anal and perianal sensation was impaired in patients with fecal impaction. These findings are similar to those described in patients with low spinal cord injuries.