Internal anal sphincter atrophy in patients with systemic sclerosis

SSc is a connective tissue, multisystem disorder of unknown aetiology. The gastrointestinal tract (GIT) is affected in up to 90% of patients. The exact pathophysiology of GIT involvement is not known, but it is related to both neurogenic and myogenic abnormalities as well as possible vascular and is...

Full description

Saved in:
Bibliographic Details
Published in:Rheumatology (Oxford, England) England), 2011-09, Vol.50 (9), p.1596-1602
Main Authors: THOUA, Nora M, SCHIZAS, Alexis, FORBES, Alastair, DENTON, Christopher P, EMMANUEL, Anton V
Format: Article
Language:English
Subjects:
Adult
Aged
Anal Canal - diagnostic imaging
Anal Canal - pathology
Biological and medical sciences
Case-Control Studies
Diseases of the osteoarticular system
Endosonography - methods
Fecal Incontinence - complications
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Intestinal Diseases - etiology
Intestinal Diseases - pathology
Male
Manometry - methods
Medical sciences
Middle Aged
Other diseases. Semiology
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Scleroderma, Systemic - complications
Scleroderma, Systemic - diagnostic imaging
Scleroderma, Systemic - pathology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Surveys and Questionnaires
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:SSc is a connective tissue, multisystem disorder of unknown aetiology. The gastrointestinal tract (GIT) is affected in up to 90% of patients. The exact pathophysiology of GIT involvement is not known, but it is related to both neurogenic and myogenic abnormalities as well as possible vascular and ischaemic changes. Thinning of the internal anal sphincter (IAS) has been demonstrated in SSc with faecal incontinence. We aimed to investigate anal sphincter structure in patients with SSc. Forty-four SSc patients [24 symptomatic (Sx) and 20 asymptomatic (ASx)] and 20 incontinent controls (ICs) were studied. Patients underwent anorectal manometry and endoanal US. In the ICs, external anal sphincter defects were more common, but the IAS was less atrophic, evident by both atrophy scores and IAS thickness. There was no significant difference in atrophy scores [Sx: 2 (1.5-3) vs ASx: 2 (1-2)] or IAS thickness [Sx: 1.85 (1.5-2.3) vs ASx: 1.8 (1.7-2.25)] between the Sx and ASx SSc patients. Patients with SSc (both Sx and ASx) have thin and atrophic IAS, suggesting that IAS atrophy develops even in ASx patients and this may be amenable to treatment with sacral neuromodulation.
ISSN:1462-0324
1462-0332
DOI:10.1093/rheumatology/ker153