Evaluation of Anorectal Function in Perianal Crohn's Disease: A Pilot Study.

BACKGROUND

Perianal Crohn's disease is a disabling condition, with little known about anorectal function in healed/inactive perianal Crohn's disease; Aim: To evaluate anorectal function in a cohort of patients with treated/healed perianal Crohn's disease;

Methods

Prospective cohort study, including high-resolution anorectal manometry, balloon expulsion test, and 3D-endoanal ultrasound in all patients;

Results

Of the 16 patients studied (mean age ± SD, 42 ± 13 years), 12 (75%) were men. A laceration of the internal anal sphincter and/or anal scarring was seen in nine (56%) patients; there was no laceration of the external anal sphincter. Five (56%) of these nine patients had never experienced faecal incontinence. All had normal anal resting and squeeze pressures. Manometry suggested dyssynergia in 11 (69%) patients, with only one (6%) fulfilling the criteria for obstructed defecation. Hyposensitivity for at least one sensory parameter was seen in 11 (69%) patients and hypersensitivity in five (31%) patients;

Conclusions

This study detected sphincter abnormalities in more than half of patients, many of whom were asymptomatic. Alterations in rectal sensation were frequently seen, more commonly with rectal hyposensitivity.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT03819257).