Anorectal functional disorders in the absence of anorectal inflammation in patients with Crohn's disease

Background: Histological alterations in the enteric nervous system (ENS) have been described in patients suffering from Crohn's disease (CD). The aim of this study was to investigate whether patients with CD without rectal inflammation have abnormal anorectal function compared with healthy volu...

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Bibliographic Details
Published in:British journal of surgery 2002-08, Vol.89 (8), p.1027-1031
Main Authors: Mueller, M. H., Kreis, M. E., Gross, M. L., Becker, H. D., Zittel, T. T., Jehle, E. C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Crohn Disease - complications
Crohn Disease - pathology
Crohn Disease - physiopathology
Fecal Incontinence - etiology
Fecal Incontinence - pathology
Fecal Incontinence - physiopathology
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Male
Manometry - methods
Medical sciences
Middle Aged
Other diseases. Semiology
Pressure
Proctitis - etiology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
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Summary:Background: Histological alterations in the enteric nervous system (ENS) have been described in patients suffering from Crohn's disease (CD). The aim of this study was to investigate whether patients with CD without rectal inflammation have abnormal anorectal function compared with healthy volunteers. Methods: Fifty‐four patients with CD and 26 healthy volunteers were examined by anorectal manometry and answered a standardized questionnaire. No patient had active CD in the rectum as determined by endoscopy. Results: Maximum anal resting and squeeze pressures did not differ between patients and healthy volunteers. The rectoanal inhibitory reflex was absent in 24 of 54 patients and two of 26 healthy volunteers (P < 0·05). The first sensation to distension of the rectal balloon was reported at mean(s.e.m.) 57·9(4·4) ml by patients and 37·5(2·2) ml by healthy volunteers (P < 0·01). The standardized interview revealed additional disorders of anorectal function in patients with CD. Conclusion: Anorectal function appears to be altered in many patients with CD even in the absence of macroscopic anorectal disease. This may be due to a disorder of the ENS. © 2002 British Journal of Surgery Society Ltd
ISSN:0007-1323
1365-2168
DOI:10.1046/j.1365-2168.2002.02173.x