New method for the dynamic assessment of anorectal function in constipation.

Area of Science:

• Gastroenterology and Radiology

Background:

• Anorectal dysfunction can cause significant difficulty passing stool.
• Accurate assessment of anorectal function during defecation is crucial for diagnosis.

Purpose of the Study:

• To introduce and validate a novel dynamic technique for investigating anorectal function.
• To compare anorectal function during voiding in patients with constipation versus healthy subjects.

Main Methods:

• Radiological visualization of the rectum using radio-opaque contrast medium during defecation.
• Simultaneous measurement of intrarectal pressure and external anal sphincter electrical activity.
• Study included 16 patients with severe difficulty passing formed stool and 6 healthy controls.

Main Results:

• The new technique successfully visualized anorectal dynamics during defecation.
• Patients exhibited abnormal increases in puborectalis and sphincter muscle activity during voiding.
• Constipated patients failed to widen the anorectal angle upon straining, unlike controls.

Conclusions:

• The developed dynamic technique provides valuable insights into anorectal function during defecation.
• Abnormal muscle activity and failure to widen the anorectal angle are key findings in patients with severe constipation.
• This method aids in understanding the pathophysiology of defecatory disorders.