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High-resolution Anorectal Manometry in Parkinson Disease With Defecation Disorder: A Comparison With Functional Defecation Disorder.
J Clin Gastroenterol. 2016 08; 50(7):566-71.JC

Abstract

GOAL

To investigate the characteristics of high-resolution anorectal manometry (HR-ARM) in Parkinson disease (PD) patients with defecation disorder (DD) compared with patients with functional defecation disorder (FDD).

BACKGROUND

DD is a common gastrointestinal symptom in PD. HR-ARM is a relatively new and reliable method for detecting DD.

STUDY

A cohort of PD patients with DD was matched with FDD patients. Defecatory symptoms were investigated by questionnaire. Anorectal motility and sensation were evaluated by HR-ARM. Differences in defecatory symptoms, sensorimotor parameters, and DD type were analyzed. Defecatory symptoms and manometric variables obtained in early-stage PD were compared with advanced stage, and relationships between manometric parameters and evacuatory symptoms explored.

RESULTS

Straining and sensation of blockage was experienced significantly more in PD than FDD, and stool consistency more severely affected. Maximum squeeze and intrarectal pressure during defecation in PD was lower than in FDD. Anal resting and residual pressures, duration of sustained squeeze, threshold volumes for first sensation, urgency, and maximum discomfort were similar between groups. PD patients presented predominantly with inadequate propulsive forces, whereas FDD patients showed dyssynergic defecation. Defecatory symptoms and manometric parameters did not differ between stages of PD.

CONCLUSIONS

PD patients with DD experienced more straining and sensation of blockage than FDD patients, possibly related to inadequate anorectal motility and paradoxical anal contraction of pelvic floor. Impaired squeeze response and inadequate propulsive forces are specific to anorectal function of PD patients with DD, compared with FDD, with abnormalities unchanged between early and advanced PD.

Authors+Show Affiliations

Departments of *Gastroenterology †Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26756106

Citation

Yu, Ting, et al. "High-resolution Anorectal Manometry in Parkinson Disease With Defecation Disorder: a Comparison With Functional Defecation Disorder." Journal of Clinical Gastroenterology, vol. 50, no. 7, 2016, pp. 566-71.
Yu T, Wang Y, Wu G, et al. High-resolution Anorectal Manometry in Parkinson Disease With Defecation Disorder: A Comparison With Functional Defecation Disorder. J Clin Gastroenterol. 2016;50(7):566-71.
Yu, T., Wang, Y., Wu, G., Xu, Q., Tang, Y., & Lin, L. (2016). High-resolution Anorectal Manometry in Parkinson Disease With Defecation Disorder: A Comparison With Functional Defecation Disorder. Journal of Clinical Gastroenterology, 50(7), 566-71. https://doi.org/10.1097/MCG.0000000000000469
Yu T, et al. High-resolution Anorectal Manometry in Parkinson Disease With Defecation Disorder: a Comparison With Functional Defecation Disorder. J Clin Gastroenterol. 2016;50(7):566-71. PubMed PMID: 26756106.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-resolution Anorectal Manometry in Parkinson Disease With Defecation Disorder: A Comparison With Functional Defecation Disorder. AU - Yu,Ting, AU - Wang,Yun, AU - Wu,Gaojue, AU - Xu,Qinrong, AU - Tang,Yurong, AU - Lin,Lin, PY - 2016/1/13/entrez PY - 2016/1/13/pubmed PY - 2017/12/8/medline SP - 566 EP - 71 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 50 IS - 7 N2 - GOAL: To investigate the characteristics of high-resolution anorectal manometry (HR-ARM) in Parkinson disease (PD) patients with defecation disorder (DD) compared with patients with functional defecation disorder (FDD). BACKGROUND: DD is a common gastrointestinal symptom in PD. HR-ARM is a relatively new and reliable method for detecting DD. STUDY: A cohort of PD patients with DD was matched with FDD patients. Defecatory symptoms were investigated by questionnaire. Anorectal motility and sensation were evaluated by HR-ARM. Differences in defecatory symptoms, sensorimotor parameters, and DD type were analyzed. Defecatory symptoms and manometric variables obtained in early-stage PD were compared with advanced stage, and relationships between manometric parameters and evacuatory symptoms explored. RESULTS: Straining and sensation of blockage was experienced significantly more in PD than FDD, and stool consistency more severely affected. Maximum squeeze and intrarectal pressure during defecation in PD was lower than in FDD. Anal resting and residual pressures, duration of sustained squeeze, threshold volumes for first sensation, urgency, and maximum discomfort were similar between groups. PD patients presented predominantly with inadequate propulsive forces, whereas FDD patients showed dyssynergic defecation. Defecatory symptoms and manometric parameters did not differ between stages of PD. CONCLUSIONS: PD patients with DD experienced more straining and sensation of blockage than FDD patients, possibly related to inadequate anorectal motility and paradoxical anal contraction of pelvic floor. Impaired squeeze response and inadequate propulsive forces are specific to anorectal function of PD patients with DD, compared with FDD, with abnormalities unchanged between early and advanced PD. SN - 1539-2031 UR - https://www.unboundmedicine.com/medline/citation/26756106/High_resolution_Anorectal_Manometry_in_Parkinson_Disease_With_Defecation_Disorder:_A_Comparison_With_Functional_Defecation_Disorder_ L2 - http://dx.doi.org/10.1097/MCG.0000000000000469 DB - PRIME DP - Unbound Medicine ER -