Revista espanola de enfermedades digestivas · 2025
Rectal sensory-motor alterations - A clinical perspective on anorectal disorders. The correlation between rectal sensation and motility in different anorectal diseases.
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Wang Xinpeng, Gao Yanhui, Xiao Li, Wang Shuang, Xu Bohong, Zhi Yu
Аннотация
BACKGROUND: Patients with anorectal diseases commonly exhibit abnormalities in rectal sensation Background: patients with anorectal diseases commonly exhibit abnormalities in rectal sensation and/or rectal motility. However, the relationship between rectal sensation and motility in these pathological processes is unclear. This study aimed to explore this association.
METHODS: a retrospective review was performed of clinical data from 954 patients with anorectal disorders and defecation problems who had undergone anorectal functional testing. The correlation between rectal sensation and motility across various conditions was investigated and the impact of physiological factors assessed.
RESULTS: significant rectal sensation differences were seen across constipation, fecal incontinence, rectal cancer, and postoperative patients, with the highest sensitivity in postoperative patients (p < 0.05). Stratified analysis showed constipated patients with rectal hyposensitivity had higher anal resting and maximum squeeze pressures, lower rectoanal gradients, manometric defecation index, and anal relaxation rate (p < 0.05). Further analysis revealed that rectal sensory parameters in constipated patients positively correlated with anal resting and maximum squeeze pressures, and negatively correlated with rectoanal gradients, manometric defecation index, and anal relaxation rate (p < 0.05), with the influence of age and gender being synergistic (p < 0.05). In rectal cancer, the maximum tolerable volume positively correlated with anal resting pressure and negatively with the rectoanal gradient and manometric defecation index (p < 0.05). This negative correlation is also observed in postoperative patients (p < 0.05).
CONCLUSIONS: in patients with anorectal disorders and defecation problems, there was a significant correlation between rectal sensory abnormalities and dynamic changes induced by varying levels of rectal sensitivity, which were modulated by physiological factors.
METHODS: a retrospective review was performed of clinical data from 954 patients with anorectal disorders and defecation problems who had undergone anorectal functional testing. The correlation between rectal sensation and motility across various conditions was investigated and the impact of physiological factors assessed.
RESULTS: significant rectal sensation differences were seen across constipation, fecal incontinence, rectal cancer, and postoperative patients, with the highest sensitivity in postoperative patients (p < 0.05). Stratified analysis showed constipated patients with rectal hyposensitivity had higher anal resting and maximum squeeze pressures, lower rectoanal gradients, manometric defecation index, and anal relaxation rate (p < 0.05). Further analysis revealed that rectal sensory parameters in constipated patients positively correlated with anal resting and maximum squeeze pressures, and negatively correlated with rectoanal gradients, manometric defecation index, and anal relaxation rate (p < 0.05), with the influence of age and gender being synergistic (p < 0.05). In rectal cancer, the maximum tolerable volume positively correlated with anal resting pressure and negatively with the rectoanal gradient and manometric defecation index (p < 0.05). This negative correlation is also observed in postoperative patients (p < 0.05).
CONCLUSIONS: in patients with anorectal disorders and defecation problems, there was a significant correlation between rectal sensory abnormalities and dynamic changes induced by varying levels of rectal sensitivity, which were modulated by physiological factors.