Anismus: a marker of multi-site functional disorders?

Abstract

Constipated patients have lower threshold sensation volume, lower constant sensation volume, and lower maximum tolerable volume than controls. Thirty-seven patients (40%) were found to have anismus, based on anorectal manometry. No significant difference was found between constipated patients with anismus and constipated patients without anismus, using anorectal manometry. Constipated patients had longer colorectal transit time than controls, but neither total nor segmental colonic transit time was correlated with the presence or absence of anismus. In patients with anismus, a higher frequency of oesophageal symptoms, dysmotility-like dyspepsia, aerophagia, functional bowel disorders, functional abdominal pain, soiling, and dyschezia was found. In addition, a higher frequency of urinary complaints, sexual complaints, and depression was found. Anismus was associated with increased awareness of constipation, abdominal bloating, and abdominal pain, but not with diarrhoea.

Functional Gastrointestinal Disorders in Obese Patients. The Importance of the Enrollment Source

“…A questionnaire about urinary (urinary incontinence, dysuria) and sexual complaints (dyspareunia, impotence) was filled out by all the patients as previously described [22].…”

Prevalence and Co-occurrence of Upper and Lower Functional Gastrointestinal Symptoms in Patients Eligible for Bariatric Surgery

“…A standard clinical questionnaire based on diagnostic questions for functional gastrointestinal disorders [23] was filled at the office (95% acceptance rate), individually, by French-reading patients (1% of our patients did not speak or write French), after a brief oral presentation of the functional digestive symptoms . Their answers were not reviewed, and the interpretation was based on the functional disorders as defined by the Rome III criteria for esophageal, gastroduodenal, and bowel functional disorders and the Rome II criteria for functional anorectal disorders. & Functional esophageal disorders, such as heartburn, chest pain of presumed esophageal origin, dysphagia, and globus, were diagnosed in the absence of both gastroesophageal reflux and histopathology-based esophageal motility disorders [2].…”

Is dynamic two-dimensional anal ultrasonography useful in the assessment of anismus? A comparison with manometry

“…Once identified and quantified, anatomical and functional changes can be correlated with clinical symptoms and proctological findings (6) . Defecography, manometry, electromyography and, more recently, dynamic magnetic resonance scanning and dynamic anorectal ultrasonography, have all been used to diagnose patients with pelvic floor dysfunctions (1,2,3,4,5,6,7,8,9,11,12,13,14,15,16,17,18,19,20,21,22,23,24,26,27,28,29,30) . Advances in ultrasound technology includes the development of the three-dimensional (3D) anorectal transducer and allows to clearly visualize the anatomic configuration of the anal canal in multiplane images (27) but the twodimensional (2D) ultrasound can be useful in the diagnosis of anorectal disease (7,10,24) .…”