Clinical study of anorectal sensation and dynamics changes in irritable bowel syndrome with constipation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

BAO Juxi ,  FENG Zuopeng , ZHANG Guangxin , QIN Chuan , YANG Ming , LI Caie

Department of Anorectal Surgery, 942 Hospital of Joint Logistic Support Unit PLA, Yinchuan 750000, P. R. China;

Corresponding?author：

FENG Zuopeng, Email: nxychzhh@163.com

Keywords：

irritable bowel syndrome with constipation; anorectal dynamic; anorectal sensation

DOI：

10.7507/1007-9424.201808068

Video：

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Objective To investigate changes in anal dynamics and anorectal sensory function in patients with irritable bowel syndrome with constipation (IBS-C) and detect its status of basin’s myoelectric pressure. Methods Thirty-six patients with IBS-C (IBS-C group) and 28 healthy volunteers (control group) were collected. The rectal-anal canal pressure and the change of the basin’s myoelectric status were detected by the ZJ-D3 gastrointestinal motility tester and bio-stimulus feedback instrument, respectively. The anal canal resting pressure, rectal resting pressure, anorectal pressure difference, length of anal canal high pressure area, rectal sensation threshold, rectal compliance, and basin’s myoelectric voltage were compared between these two groups. Results There were no significant differences in the rectal resting pressure and anal canal resting pressure between the IBS-C group and the control group (t=–2.312, P=0.851; t=–5.464, P=0.283), but the difference value of anorectal pressure of the IBS-C group was significantly higher than that of the control group (t=4.371, P=0.017), and the length of the anal canal hypertension area in the IBS-C group was significantly longer than that of the control group (t=6.180, P=0.042). The maximal and minimum basin’s myoelectric voltage and frequency of the basin’s myoelectric voltage in the IBS-C group were significantly higher than those in the control group (t=3.386, P=0.031; t=5.763, P=0.042; t=8.410, P<0.001). Conclusion Anorectal dynamics and rectal sensory dysfunction are one of important causes of IBS-C, it might be existed abnormal changes in basin’s myoelectric voltage.

Citation： BAO Juxi, FENG Zuopeng, ZHANG Guangxin, QIN Chuan, YANG Ming, LI Caie. Clinical study of anorectal sensation and dynamics changes in irritable bowel syndrome with constipation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(1): 38-41. doi: 10.7507/1007-9424.201808068 Copy

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2.	Lacy BE. Review article: an analysis of safety profiles of treatments for diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther, 2018, 48(8): 817-8304.
3.	Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA, 2015, 313(9): 949-958.
4.	杜海濤, 陳崢, 萬軍. 腸易激綜合征的病理機制研究進展. 解放軍醫學院學報, 2017, 38(1): 85-88.
5.	Ek WE, Reznichenko A, Ripke S, et al. Exploring the genetics of irritable bowel syndrome: a GWA study in the general population and replication in multinational case-control cohorts. Gut, 2015, 64(11): 1774-1782.
6.	Gupta A. Peripheral mechanisms in irritable bowel syndrome. N Engl J Med, 2013, 368(6): 578.
7.	Fukudo S, Kaneko H, Akiho H, et al. Evidence-based clinical practice guidelines for irritable bowel syndrome. J Gastroenterol, 2015, 50(1): 11-30.
8.	羅哲, 崔立紅, 賀星. 腸道菌群失調與腸易激綜合征關系的研究進展. 解放軍醫學院學報, 2015, 36(10): 1011-1013.
9.	弓三東, 崔立紅. 糞菌移植在腸易激綜合征中的研究進展. 解放軍醫學院學報, 2015, 36(10): 1006-1010.
10.	李超, 遲雁, 王化虹, 等. 腹瀉型腸易激綜合征患者肛管直腸動力及感覺功能與外周血肥大細胞類胰蛋白酶的相關性研究. 中國全科醫學, 2017, 20(11): 1320-1325.
11.	Drossman DA. The functional gastrointestinal disorders and the Rome Ⅱ process. Gut, 1999, 45(Suppl 2): I1-I5.
12.	葉彬, 陳春曉. 老年住院慢性便秘患者的焦慮抑郁狀態和睡眠狀況. 中國老年學雜志, 2016, 36(8): 1996-1998.
13.	竇迎春, 曲海霞, 許倩倩, 等. 焦慮及抑郁評分與慢性便秘患者臨床不同伴隨癥狀關系研究. 胃腸病學和肝病學雜志, 2018, 27(8): 896-899.
14.	羅敏, 李峨, 李國棟, 等. 肛管直腸壓力測定在肛門功能評估中的價值及臨床應用. 現代中西醫結合雜志, 2012, 21(18): 1946-1947.
15.	段建華, 趙洪川. 便秘型腸易激綜合征患者結、直腸肛門動力學的臨床研究. 胃腸病學和肝病學雜志, 2006, 15(2): 191-193.
16.	顏文娟, 李蜀豫. 便秘型腸易激綜合征患者直腸肛管壓力的改變與焦慮/抑郁情緒測定評分的臨床意義. 臨床消化病雜志, 2014, 26(4): 230-232.
17.	王曉玉, 羅新. 盆底功能障礙的生物反饋治療和電刺激治療. 中國實用婦科與產科雜志, 2009, 22(7): 559-560.
18.	劉玲玲, 馮珍. 肌電生物反饋的臨床研究及應用進展. 中國康復醫學雜志, 2012, 27(3): 289-292.
19.	王夢欣, 宋冬玲, 簡佳. 肌電生物反饋對難治性腸易激綜合征內臟痛覺敏感的影響. 中華物理醫學與康復雜志, 2009, 31(1): 26-29.
20.	季新濤, 丁義江. 生物反饋治療便秘的現狀. 結直腸肛門外科, 2008, 14(6): 385-387.
21.	Kosako M, Akiho H, Miwa H, et al. Impact of symptoms by gender and age in Japanese subjects with irritable bowel syndrome with constipation (IBS-C): a large population-based internet survey. Biopsychosoc Med, 2018, 12: 12.
22.	張璐, 段麗萍, 劉懿萱, 等. 中國人群腸易激綜合征患病率和相關危險因素的 Meta 分析. 中華內科雜志, 2014, 53(12): 969-975.
23.	Adeyemo MA, Spiegel BM, Chang L. Meta-analysis: do irritable bowel syndrome symptoms vary between men and women. Aliment Pharmacol Ther, 2010, 32(6): 738-755.
24.	Simrén M, Barbara G, Flint HJ, et al. Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut, 2013, 62(1): 159-176.
25.	Dupont HL. Review article: evidence for the role of gut microbiota in irritable bowel syndrome and its potential influence on therapeutic targets. Aliment Pharmacol Ther, 2014, 39(10): 1033-1042.
26.	羅勰林. 生物刺激反饋儀結合盆底肌訓練療法對產后盆底肌功能康復效果觀察. 中國醫療器械信息, 2017, 23(14): 84-85.
27.	李曉霞, 夏泳, 鄭琳. 生物反饋電刺激結合盆底肌訓練療法對產后盆底肌功能康復效果觀察. 中國實用婦科與產科雜志, 2012, 28(6): 442-444.

1. Mearin F, Lacy BE, Chang L, et al. Bowel disorders. Gastroenterology, 2016 Feb 18. pii: S0016-5085(16)00222-5.
2. Lacy BE. Review article: an analysis of safety profiles of treatments for diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther, 2018, 48(8): 817-8304.
3. Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA, 2015, 313(9): 949-958.
4. 杜海濤, 陳崢, 萬軍. 腸易激綜合征的病理機制研究進展. 解放軍醫學院學報, 2017, 38(1): 85-88.
5. Ek WE, Reznichenko A, Ripke S, et al. Exploring the genetics of irritable bowel syndrome: a GWA study in the general population and replication in multinational case-control cohorts. Gut, 2015, 64(11): 1774-1782.
6. Gupta A. Peripheral mechanisms in irritable bowel syndrome. N Engl J Med, 2013, 368(6): 578.
7. Fukudo S, Kaneko H, Akiho H, et al. Evidence-based clinical practice guidelines for irritable bowel syndrome. J Gastroenterol, 2015, 50(1): 11-30.
8. 羅哲, 崔立紅, 賀星. 腸道菌群失調與腸易激綜合征關系的研究進展. 解放軍醫學院學報, 2015, 36(10): 1011-1013.
9. 弓三東, 崔立紅. 糞菌移植在腸易激綜合征中的研究進展. 解放軍醫學院學報, 2015, 36(10): 1006-1010.
10. 李超, 遲雁, 王化虹, 等. 腹瀉型腸易激綜合征患者肛管直腸動力及感覺功能與外周血肥大細胞類胰蛋白酶的相關性研究. 中國全科醫學, 2017, 20(11): 1320-1325.
11. Drossman DA. The functional gastrointestinal disorders and the Rome Ⅱ process. Gut, 1999, 45(Suppl 2): I1-I5.
12. 葉彬, 陳春曉. 老年住院慢性便秘患者的焦慮抑郁狀態和睡眠狀況. 中國老年學雜志, 2016, 36(8): 1996-1998.
13. 竇迎春, 曲海霞, 許倩倩, 等. 焦慮及抑郁評分與慢性便秘患者臨床不同伴隨癥狀關系研究. 胃腸病學和肝病學雜志, 2018, 27(8): 896-899.
14. 羅敏, 李峨, 李國棟, 等. 肛管直腸壓力測定在肛門功能評估中的價值及臨床應用. 現代中西醫結合雜志, 2012, 21(18): 1946-1947.
15. 段建華, 趙洪川. 便秘型腸易激綜合征患者結、直腸肛門動力學的臨床研究. 胃腸病學和肝病學雜志, 2006, 15(2): 191-193.
16. 顏文娟, 李蜀豫. 便秘型腸易激綜合征患者直腸肛管壓力的改變與焦慮/抑郁情緒測定評分的臨床意義. 臨床消化病雜志, 2014, 26(4): 230-232.
17. 王曉玉, 羅新. 盆底功能障礙的生物反饋治療和電刺激治療. 中國實用婦科與產科雜志, 2009, 22(7): 559-560.
18. 劉玲玲, 馮珍. 肌電生物反饋的臨床研究及應用進展. 中國康復醫學雜志, 2012, 27(3): 289-292.
19. 王夢欣, 宋冬玲, 簡佳. 肌電生物反饋對難治性腸易激綜合征內臟痛覺敏感的影響. 中華物理醫學與康復雜志, 2009, 31(1): 26-29.
20. 季新濤, 丁義江. 生物反饋治療便秘的現狀. 結直腸肛門外科, 2008, 14(6): 385-387.
21. Kosako M, Akiho H, Miwa H, et al. Impact of symptoms by gender and age in Japanese subjects with irritable bowel syndrome with constipation (IBS-C): a large population-based internet survey. Biopsychosoc Med, 2018, 12: 12.
22. 張璐, 段麗萍, 劉懿萱, 等. 中國人群腸易激綜合征患病率和相關危險因素的 Meta 分析. 中華內科雜志, 2014, 53(12): 969-975.
23. Adeyemo MA, Spiegel BM, Chang L. Meta-analysis: do irritable bowel syndrome symptoms vary between men and women. Aliment Pharmacol Ther, 2010, 32(6): 738-755.
24. Simrén M, Barbara G, Flint HJ, et al. Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut, 2013, 62(1): 159-176.
25. Dupont HL. Review article: evidence for the role of gut microbiota in irritable bowel syndrome and its potential influence on therapeutic targets. Aliment Pharmacol Ther, 2014, 39(10): 1033-1042.
26. 羅勰林. 生物刺激反饋儀結合盆底肌訓練療法對產后盆底肌功能康復效果觀察. 中國醫療器械信息, 2017, 23(14): 84-85.
27. 李曉霞, 夏泳, 鄭琳. 生物反饋電刺激結合盆底肌訓練療法對產后盆底肌功能康復效果觀察. 中國實用婦科與產科雜志, 2012, 28(6): 442-444.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical study of anorectal sensation and dynamics changes in irritable bowel syndrome with constipation

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