The gender differences of anal rectal function and depression and / or anxiety in elderly patients with constipation / 中国医师进修杂志

ABSTRACT

Objective To investigate the gender differences of anal rectal function and depression and/or anxiety in elderly patients with functional constipation (FC).Methods Twenty-seven elder female FC patients (elder female patients group),20 elder male FC patients (elder male FC patients group),28 elder healthy female (elder healthy female group) and 24 elder healthy male (elder healthy male group) were selected.The gender differences and correlation of anal rectal function and psychological factors were compared in elderly patients and control group,by using anorectal manometry and psychological testing methods.Results Compared with elder healthy female group,maximum squeeze pressure (MSP),anorectal pressure decreased in elder healthy male group(P ＜ 0.05 or ＜ 0.01),anal canal overpressure,first sensation volume(FSV),defecating sensation volume(DSV),maximum tolerable volume(MTV) increased in elder female patients group (P＜ 0.01).Compared with elder male healthy group,anal canal excess pressure increased,anorectal pressure decreased (P＜ 0.05),and FSV,DSV,MTV increased in elder male patients group (P ＜ 0.01 or ＜ 0.05).MSP,rectum systolic pressure,anorectal pressure in elder female patients group was lower than that in elder male patients group (P ＜ 0.05 or ＜ 0.01),rectal tube excess pressure and rectal sensation threshold was higher than that in elder male patients group,but there was no significant difference (P ＞ 0.05).RRP,rectum systolic pressure,anorectal pressure in elder female healthy group was lower than that in elder male healthy group (P ＜ 0.01).FSV was higher than that in elder male healthy group (P ＜ 0.01).SAS score and SDS score was higher in elder female patients group was higher than that in elder female healthy group (P＜ 0.01),SAS score and SDS score was higher in elder male patients group was higher than that in elder male healthy group(P＜ 0.05 or ＜ 0.01).SAS score was negatively correlated with MSP,rectum systolic pressure,anorectal pressure(P ＜ 0.01),was positively correlated with FSV(P ＜ 0.05).SDS score was negatively correlated with anorectal pressure (P ＜ 0.01),was positively correlated with FSV,DSV,MTV (P ＜0.01).Conclusions Anorectal dys function and psychological factors are involved in the elderly FC pathogenesy,and the two are related.Elderly female patients exist more severe anxiety and anorectal motility disorders than male patients.