Impact of Inflammatory Activity on Anorectal Function in Patients With Ulcerative Colitis: A Prospective Study

Area of Science:

• Gastroenterology and Colorectal Surgery
• Physiology and Pathophysiology

Background:

• Anorectal symptoms are prevalent in ulcerative colitis (UC) patients.
• The precise relationship between UC inflammatory activity and anorectal dysfunction is not fully understood.

Purpose of the Study:

• To investigate the impact of active ulcerative colitis (UC) inflammation on anorectal function.
• To determine how inflammatory activity affects the development and persistence of anorectal symptoms in UC.

Main Methods:

• Prospective observational study involving UC patients with active disease and healthy controls.
• Utilized high-resolution anorectal manometry (HR-ARM) and rectal electronic barostat testing.
• Assessments conducted during active disease and post-treatment (4-6 months).

Main Results:

• Active UC disease correlated with increased fecal incontinence, urgency, and tenesmus.
• Higher endoscopic and histological activity linked to reduced rectal sensory thresholds, capacity, and compliance.
• Altered anorectal function persisted post-treatment, even in patients achieving remission.

Conclusions:

• Inflammatory activity in UC directly impairs anorectal function, increasing rectal sensitivity and decreasing compliance/capacity.
• This dysfunction contributes to persistent anorectal symptoms in UC patients.
• The findings underscore the need for specific diagnostic and therapeutic approaches for anorectal involvement in UC.