ABSTRACT
Objective To acquire normative values of anorectal manometry and sensation in population of our country with different gender and age.Methods Healthy individuals from four medical centers were collected and divided into three group according to their age,group Ⅰ 18 - 39 years old, group Ⅱ 40-59 years old and group Ⅲ ≥60 years old.The parameters of anal of subjects at resting status was examined by pneumohydraulic capillary perfusion system and high resolution PC Polygraf HR desktop gastrointestinal dynamic monitoring system.Subjects were asked to simulate defecation and then the defecation related indexes were recorded.In the end rectoanal inhibitory reflexes (RAIR)and rectal sensation were assessed by aired balloon.One-way analysis of variance and independent sample test were performed to compare indexes among three groups with different age and between different genders. Results A total of 166 healthy subjects were enrolled,79 in group Ⅰ with 40 male,68 in group Ⅱ with 29 male and 19 in group Ⅲ with 11 male.There was no significant difference in anal sphincter length (ASL),valid anal sphincter length (VASL),resting anal sphincter pressure (RASP),squeeze anal sphincter pressure (SASP)and duration of valid squeeze anal sphincter pressure (VSASP)among three groups with different age (all P > 0.05 ).Compared between male and female,only SASP of male ((180.13±8.10)mmHg,1 mmHg=0.133 kPa)was significantly higher than that of female ((143.93± 6.59)mmHg,t = -3.489,P 0.05 ). There was no significant difference in rectal pressure (RP),rectoanal pressure gradient (RAPG),anal sphincter relaxation rate (ASRR),and rectoanal coordination (RAC)among three groups (all P >0.05). During simulated defecation,RP and RAPG of men ((61 .23±3.46)mmHg and (40.04±4.08)mmHg) were significantly higher than those of women ((44.47 ± 2.32)mmHg and (24.00 ± 2.59 )mmHg, t=-4.075 ,-3.367,both P 0.05).All participants had RAIR,and there was no significant difference neither among three groups nor between men and women (both P >0.05).There was no significant difference in first rectal sensation (FRS)and constant rectal sensation (CRS)among three groups with different age (all P >0.05).However,the maximum rectal tolerable sensation (MRTS)of group Ⅱ and group Ⅲ was significantly higher than that of group Ⅰ ((194.41 ±6.32)mL and (200.00±12.75)mL vs (167.80 ± 5 .00)mL,F = 6.698,P = 0.002).There was no significant difference in rectal sensation between different gender (all P >0.05 ).Conclusions In our country,SASP,RP and RAPG during simulated defecation of male are higher than those of female.The value of MRTS increases along with the age.
ABSTRACT
Objective To assess short term results of papilla functional status after endoscopic sphincterotomy (EST) with thin-barium meal examination.Methods From August, 2001 to December, 2003, eighty-nine patients were included for endoscopic sphincterotomy. Size of EST was (0.5～1.5) cm. Patients were prospectively followed on the short term-period (7 days, 6 months and 1 year) by clinical and thin-barium(100/100 V/W) meal examination which would be observed biliary gas and barium reflux from duodenal papilla.Results The patient number of gas reflux shows: 19 of 89 cases(21.3%) in one week, 5 of 36 cases(13.9%) in six months, 13 of 23 cases (13.0%)in one year; barium reflux with thin-barium meal examination shows: 11 of 89 cases(12.4%) in one week, 3 of 36 cases(8.3%) in six months, 2 of 23 cases(8.7%) in one year. In the size of EST more than 1.1 cm, these were nine patients (47.4%) with gas reflux, and seven patients (36.8%) with barium reflux, and five patients with gas-barium mix reflux. 6 month and 1 year after sphincterotomy, includes EST size 1.2 cm,2 cases and 1.5 cm,3 cases.Conclusion Thin-barium meal examination of papilla function after endoscopic sphincterotomy is an efficient procedure. Incidence rate of gas reflux and thin barium reflux were closely related to the size of EST.