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Anorectal dysfunction and rectal prolapse in progressive systemic sclerosis

J A Leighton1, M A Valdovinos, J H Pemberton

  • 1Gastroenterology Research Unit, Mayo Clinic, Rochester, Minnesota 55905.

Diseases of the Colon and Rectum
|February 1, 1993
PubMed
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Progressive systemic sclerosis (PSS) frequently causes anorectal dysfunction, leading to altered bowel movements and fecal incontinence. Addressing rectal prolapse is crucial as it worsens anal sphincter weakness and incontinence in PSS patients.

Area of Science:

  • Gastroenterology
  • Rheumatology
  • Colorectal Surgery

Background:

  • Gastrointestinal (GI) involvement is common in progressive systemic sclerosis (PSS).
  • Anorectal dysfunction can significantly impact quality of life in PSS patients.

Purpose of the Study:

  • To characterize the clinical spectrum of anorectal dysfunction in patients with PSS.
  • To investigate the relationship between PSS, anorectal function, and fecal incontinence.

Main Methods:

  • Clinical assessment including physical examination, proctosigmoidoscopy, and anorectal manometry.
  • Barium studies, endoscopy, and manometry to assess other digestive tract regions.
  • Evaluation of fecal incontinence and rectal prolapse prevalence.

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Main Results:

  • All eight PSS patients exhibited abnormal anorectal function, with reduced anal sphincter resting pressures.
  • Seven patients experienced fecal incontinence; four had rectal prolapse, associated with lower sphincter pressures.
  • Impaired rectal capacity and compliance were noted in all seven patients assessed.
  • Surgical correction of rectal prolapse improved incontinence in two of three patients.

Conclusions:

  • Rectal dysfunction and anal sphincter weakness are key contributors to altered bowel movements and fecal incontinence in PSS.
  • Rectal prolapse exacerbates anal sphincter dysfunction and fecal incontinence, necessitating routine screening and management.