Anismus in patients with normal and slow transit constipation

✍ Scribed by R. Miller; G. S. Duthie; Mr. D. C. C. Bartolo; A. M. Roe; J. Locke-Edmunds; N. J. McC. Mortense

• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 337 KB
• Volume: 78
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800780619

✦ Synopsis

Anismus in patients with normal and slow transit constipation

This study examined diferences in anorectal function, with particular reference to anismus, which might explain why some patients with intractable constipation have slow and others have normal whole gut transit times. Twenty-four patients were studied; 13 with slow transit (all female, median age 32 years, range 16-52 years) and 11 with normal transit (eight women, three men, median age 37 years, range 21-60 years). Videoproctography with synchronous sphincteric electromyography and anorectal manometry was performed. There were no dtferences between the two groups, suggesting that slow transit constipation is not secondary to any abnormality in anorectal function and may therefore be a primary disorder of colonic motility. There was no correlation between electromyographic evidence of anismus (pelvic .poor contraction on defaecation) and the ability of the patient to evacute the rectum or symptoms of obstructed defaecation. Electromyography $findings alone can be misleading and should be related to proctographic evidence of incomplete rectal evacuation before functional anismus can be said to be present.