Tags

Type your tag names separated by a space and hit enter

Chronic neurogenic lesions of the external anal sphincter and abdomino-perineal dyssynergia in chronic constipation.
Ital J Gastroenterol Hepatol. 1999 Oct; 31(7):574-9.IJ

Abstract

BACKGROUND

Neuropathy of the pudendal nerves which may be found in constipated patients has been considered the result of pelvic floor descent due to the repetitive acts of straining at stool. However, the relationship between abdominopelvic dyssynergia, which may lead to repetitive acts of straining and neurophysiopathologic alterations of the pelvic floor has not yet been fully elucidated.

AIM

Of this study was to assess the relationship between neurophysiologic alterations of the external anal sphincter, patterns of altered evacuation and defaecographic pelvic floor physiology in 32 patients with chronic idiopathic constipation.

RESULTS

At electromyography partial muscle denervation, identified as chronic neurogenic lesions of the external anal sphincter, were found in 19% and dyssynergia (co-contraction of external anal sphincter and abdominal muscles) in 34% of the investigated subjects. Patients with different electromyography patterns did not differ as far as concerns symptoms of altered evacuation, bowel frequency, use of digital manoeuvres, age, and duration of symptoms. The presence of neurophysiologic alterations was significantly associated with altered defaecographic findings: reduced ano-rectal angle at rest in chronic neurogenic lesions and abdomino-pelvic dyssynergia (p < 0.01); excessive pelvic floor descent in the presence of chronic neurogenic lesions (p < 0.05).

CONCLUSIONS

In chronically constipated patients symptoms of altered defaecation do not appear to be related to abdomino-pelvic dyssynergia and/or chronic neurogenic lesion of the external anal sphincter and do not show any association with defaecographic alterations. These results suggest that straining at evacuation can be induced by additional factors other than abdomino-pelvic dyssynergia and chronic neurogenic lesions and that these two alterations have different pathogenetic mechanisms.

Authors+Show Affiliations

Department of Clinical Science, University La Sapienza, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10604095

Citation

Habib, F I., et al. "Chronic Neurogenic Lesions of the External Anal Sphincter and Abdomino-perineal Dyssynergia in Chronic Constipation." Italian Journal of Gastroenterology and Hepatology, vol. 31, no. 7, 1999, pp. 574-9.
Habib FI, Inghilleri M, Badiali D, et al. Chronic neurogenic lesions of the external anal sphincter and abdomino-perineal dyssynergia in chronic constipation. Ital J Gastroenterol Hepatol. 1999;31(7):574-9.
Habib, F. I., Inghilleri, M., Badiali, D., & Corazziari, E. (1999). Chronic neurogenic lesions of the external anal sphincter and abdomino-perineal dyssynergia in chronic constipation. Italian Journal of Gastroenterology and Hepatology, 31(7), 574-9.
Habib FI, et al. Chronic Neurogenic Lesions of the External Anal Sphincter and Abdomino-perineal Dyssynergia in Chronic Constipation. Ital J Gastroenterol Hepatol. 1999;31(7):574-9. PubMed PMID: 10604095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic neurogenic lesions of the external anal sphincter and abdomino-perineal dyssynergia in chronic constipation. AU - Habib,F I, AU - Inghilleri,M, AU - Badiali,D, AU - Corazziari,E, PY - 1999/12/22/pubmed PY - 1999/12/22/medline PY - 1999/12/22/entrez SP - 574 EP - 9 JF - Italian journal of gastroenterology and hepatology JO - Ital J Gastroenterol Hepatol VL - 31 IS - 7 N2 - BACKGROUND: Neuropathy of the pudendal nerves which may be found in constipated patients has been considered the result of pelvic floor descent due to the repetitive acts of straining at stool. However, the relationship between abdominopelvic dyssynergia, which may lead to repetitive acts of straining and neurophysiopathologic alterations of the pelvic floor has not yet been fully elucidated. AIM: Of this study was to assess the relationship between neurophysiologic alterations of the external anal sphincter, patterns of altered evacuation and defaecographic pelvic floor physiology in 32 patients with chronic idiopathic constipation. RESULTS: At electromyography partial muscle denervation, identified as chronic neurogenic lesions of the external anal sphincter, were found in 19% and dyssynergia (co-contraction of external anal sphincter and abdominal muscles) in 34% of the investigated subjects. Patients with different electromyography patterns did not differ as far as concerns symptoms of altered evacuation, bowel frequency, use of digital manoeuvres, age, and duration of symptoms. The presence of neurophysiologic alterations was significantly associated with altered defaecographic findings: reduced ano-rectal angle at rest in chronic neurogenic lesions and abdomino-pelvic dyssynergia (p < 0.01); excessive pelvic floor descent in the presence of chronic neurogenic lesions (p < 0.05). CONCLUSIONS: In chronically constipated patients symptoms of altered defaecation do not appear to be related to abdomino-pelvic dyssynergia and/or chronic neurogenic lesion of the external anal sphincter and do not show any association with defaecographic alterations. These results suggest that straining at evacuation can be induced by additional factors other than abdomino-pelvic dyssynergia and chronic neurogenic lesions and that these two alterations have different pathogenetic mechanisms. SN - 1125-8055 UR - https://www.unboundmedicine.com/medline/citation/10604095/Chronic_neurogenic_lesions_of_the_external_anal_sphincter_and_abdomino_perineal_dyssynergia_in_chronic_constipation_ L2 - http://www.diseaseinfosearch.org/result/1885 DB - PRIME DP - Unbound Medicine ER -