ABSTRACT
Forty-eight patients of median age 57 years with neurogenic faecal incontinence and 44 normal subjects of median age 51 years underwent fine-wire anal sphincter electromyography and anal manometry. The median (interquartile range (i.q.r.)) internal anal sphincter (IAS) electromyogram frequency was 0.26 (0.21-0.32) Hz for patients with faecal incontinence and 0.44 (0.31-0.55) Hz for controls (P < 0.01). The median (i.q.r.) ambulatory resting pressure was 48 (34-68) cmH2O for patients and 86 (72-102) cmH2O for controls (P < 0.01) and median (i.q.r.) frequency of transient IAS relaxations 9 (7-12) and 4 (3-7) per h respectively (P < 0.05). Mid-anal pressure fell to a greater extent in patients with incontinence during these episodes of transient IAS relaxation. Rectal pressure during such relaxation did not exceed mid-anal canal pressure in controls; for the patient group, rectal pressure increased during relaxation and exceeded mid-anal canal pressure in 36 cases. Frequent abnormal episodes of IAS relaxation may cause occult faecal leakage in patients with neurogenic faecal incontinence.
Subject(s)
Anal Canal/physiopathology , Fecal Incontinence/physiopathology , Adult , Aged , Aged, 80 and over , Electromyography/methods , Female , Humans , Male , Middle Aged , Muscle Relaxation , PressureABSTRACT
During three successive summer grazing periods, several young Friesian cross heifers developed an increasingly severe upper respiratory syndrome which improved soon after the animals were housed. The major clinical signs during the third summer episode were: ocular and nasal discharge; ulceration of the nasal mucosa, which was swollen, causing obstruction of the nasal passages; and the presence of large numbers of small, hard, white nodules in the nasal vestibules. From these clinical and epidemiological findings, a diagnosis of atopic rhinitis was made.
