Relationship between clinical symptoms and manometric findings in women with functional constipation

Document Type : Original article

Authors

1 1. Student Research Committee. Msc. Department of Physical Therapy. Faculty of Rehabilitation Scienses. Shahid Beheshti University of Medical Science. Tehran. Iran.

2 2. Assistant Professor of Physical Therapy. Faculty of Rehabilitation Scienses, Shahid Beheshti University of Medical Science. Tehran. Iran.

3 3. Assistant Professor, Department of Medical Sciences, Shahid Beheshti University of Medical Sciences, Velenjak, Tehran, Iran

4 4. Associate Professor of Biostatistics, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background and Aim: Functional constipation is a widely prevalent anorectal condition. The most commonly used instrument to evaluate constipation is the Rome III criteria. Clinical diagnostic techniques such as anorectal manometry is also performed to assess constipation. Issues of cost, accessibility, requirement for specialized skill and denial of patient comfort, makes its use waned. Rome III criteria can be used as an assessment tool easier than the other modalities, such as manometry. Therefore, this study aimed to investigate the relationship between clinical symptoms based on Rome III criteria with manometric findings in women with functional constipation.
Material & Methods: 35 female patients with a mean age of 38.51  10.24 years and functional constipation diagnosed by specialist were included in this study. After complication of Rome III criteria and background information questionnaire, digital evaluation and anorectal manometry were assessed. For data analysis SPSS software version 22, Pearson and Spearman correlation coefficient was used.
Results: Our results indicated significant negative correlation between the severity of Rome III criteria pressure of upper anal during squeeze and push maneuver, between rectal, upper anal resting pressure and level of gas or fecal incontinence and between rectal pressure of squeeze with number of delivery and also between severity of Rome III criteria and strength and endurance of pelvic floor muscles by digital assessment. Positive correlation between lower anal pressure during push and resting tone was observed (p<0.05).
Conclusion: According to this study, the clinical assessment of patients with functional constipation, Rome III criteria and manual pelvic floor muscle examination such as strength and endurance, as a non-invasive and low cost method is recommended. However, to achieve an accurate diagnosis, in addition to the mentioned methods, the use of anorectal manometry is recommended.

Keywords

References

  1. Jamshed, N., Z.-E. Lee, and K.W. Olden, Diagnostic approach to chronic constipation in adults. American family physician. 84(3): p. 299-306.##
  2. Phillips, C., et al., Assessment of constipation management in long-term care patients. Journal of the American Medical Directors Association, 2001. 2(4): p. 149-154.##
  3. Mugie, S.M., M.A. Benninga, and C. Di Lorenzo, Epidemiology of constipation in children and adults: a systematic review. Best practice & research Clinical gastroenterology. 25(1): p. 3-18.##
  4. Rao, S.S., Constipation: evaluation and treatment of colonic and anorectal motility disorders. Gastrointestinal endoscopy clinics of North America, 2009. 19(1): p. 117-139.##
  5. McCrea, G.L., et al., A review of the literature on gender and age differences in the prevalence and characteristics of constipation in North America. Journal of pain and symptom management, 2009. 37(4): p. 737-745.##
  6. Remes-Troche, J.M. and S.S. Rao, Diagnostic testing in patients with chronic constipation. Current gastroenterology reports, 2006. 8(5): p. 416-424.##
  7. Garrigues, V., et al., Prevalence of constipation: agreement among several criteria and evaluation of the diagnostic accuracy of qualifying symptoms and self-reported definition in a population-based survey in Spain. American journal of epidemiology, 2004. 159(5): p. 520-526.##
  8. Varma, M.G., et al., The constipation severity instrument: a validated measure. Diseases of the Colon & Rectum, 2008. 51(2): p. 162-172.##
  9. Joshi, H. and O. Jones, Clinical, radiological and physiological assessment of anorectal function. Surgery (Oxford). 32(8): p. 404-407.##
  10. Van Koughnett, J.A.M. and G. Da Silva, Anorectal Physiology and Testing. Gastroenterology Clinics of North America. 42(4): p. 713-728.##
  11. Sun, W.M. and S.S. Rao, Manometric assessment of anorectal function. Gastroenterology Clinics of North America, 2001. 30(1): p. 15-32.##
  12. Whitehead, W.E. and M.M. Schuster, Manometric and electromyographic techniques for assessment of the anorectal mechanism for continence and defecation, in Psychophysiology of the Gastrointestinal Tract. 1983, Springer. p. 311-329.##
  13. Lang, J.E., H. Brown, and E. Crombie, Assessment of the anal sphincter muscle: Comparison of a digital and a manometric technique. Physiotherapy, 2007. 93(2): p. 121-128.##
  14. Chaliha, C., et al., Anal function: effect of pregnancy and delivery. American journal of obstetrics and gynecology, 2001. 185(2): p. 427-432.##
  15. Zetterstrà m, J., et al., Effect of delivery on anal sphincter morphology and function. Diseases of the Colon & Rectum, 1999. 42(10): p. 1253-1260.##
  16. Tantiphlachiva, K., et al., Digital rectal examination is a useful tool for identifying patients with dyssynergia. Clinical Gastroenterology and Hepatology. 8(11): p. 955-960.##
  17. Rao, S., et al., Investigation of the utility of colorectal function tests and Rome II criteria in dyssynergic defecation (Anismus). Neurogastroenterology & Motility, 2004. 16(5): p. 589-596.##
  18. Bassotti, G. and V. Villanacci, A practical approach to diagnosis and management of functional constipation in adults. Internal and emergency medicine. 8(4): p. 275-282.##
  19. Bharucha, A.E., J.H. Pemberton, and G.R. LOCKE III, American Gastroenterological Association technical review on constipation. Gastroenterology. 144(1): p. 218.##
  20. Rao, S., et al., Minimum standards of anorectal manometry. Neurogastroenterology & Motility, 2002. 14(5): p. 553-559.##
  21. Barnes, P. and J. Lennard-Jones, Function of the striated anal sphincter during straining in control subjects and constipated patients with a radiologically normal rectum or idiopathic megacolon. International journal of colorectal disease, 1988. 3(4): p. 207-209.

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The Scientific Journal of Rehabilitation Medicine
Volume 4, Issue 3 - Serial Number 3
September and October 2015
Pages 94-100

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History

  • Receive Date: 31 January 2015
  • Revise Date: 19 May 2015
  • Accept Date: 14 July 2015
  • First Publish Date: 23 September 2015

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