[Functional study of the anorectal region in hemorrhagic rectocolitis]

Because the rectum is always severely affected by haemorrhagic procto-colitis, the functional investigation of the ano-rectal region is an essential element in the pathophysiological approach and the objective evaluation of functional disorders (urgency of stools, number of stools per 24 hours, incontinence) described by patients. In fact, the rectum is a compliant organ which behaves like a reservoir between the propulsive colinic element and the resistant anal element and it plays an essential role in the continence of faeces. The work of Farthing et al. and Denis et al. in cases of non-operated haemorrhagic procto-colitis have demonstrated: an abnormal sensitivity of the rectum to disension, a significant reduction in the rectal capacity and a decrease in the distensibility of the rectal wall. The abnormalities appear to be related to inflammation of the rectal mucosa. The studies reported by Denis et al. and by Zielinski et al. suggest that there is a functional adaptation of the rectal wall after ileo-rectal anastomosis for heamorrhagic procto-colitis, even in endoscopically severe forms.