Anorectal Manometry Profile among Patients with Chronic Constipation and Faecal Incontinence in Western India: A Retrospective Study

Abstract

Introduction: About 50% of patients referred to tertiary care centre for constipation in the western countries have faecal evacuation disorder. A diagnosis of faecal evacuation disorder requires specialised investigations such as anorectal manometry. Anorectal manometry is a method to measure pressure exerted by the muscles in anus and rectum. Aim: To evaluate the characteristics of anorectal pressure in a cohort of western Indian patients with chronic constipation and faecal incontinence. Also, to evaluate the types of faecal evacuation disorders in patients with chronic constipation. Materials and Methods: The present retrospective study was conducted from January 2020 to May 2022 at Department of Gastroenterology, National Institute of Medical College and Research, Jaipur, India. Total of 115 patients who presented with chronic constipation and faecal incontinence were included in the study. Sigmoidoscopy or full-length colonoscopy, Balloon Expulsion Test (BET) and anorectal manometry test were done in all the patients. Mean resting and squeeze pressure were measured by anorectal manometry. Continuous variables were summarised using means and standard deviations for normally distributed data. Statistical analysis was performed using Statistical Package for Social Sciences software (SPSS) version 20.0 (IBM Corp, Armonk, NY, USA). Results: Among 115, 62 were (53.9%) males and 53 (46.1%) females with mean age 51.9±16.2 years. In High Resolution Anorectal Manometry (HRAM), the mean resting anal pressure was 67.2±34.24 mmHg (range 14-183 mmHg) and mean squeeze pressure was 113.4±60.9 mmHg (range 30-290 mmHg). In present study type I dyssynergic defecations was most common with 20 (17.4%) patients. Conclusion: The present study showed that almost half of the patients had defecation disorders and type I dyssynergic defecations was most common, followed by type IV.

Keywords

• balloon expulsion test
• dyssynergic defecation
• solitary rectal ulcer syndrome