ABSTRACT
INTRODUCTION: Many diabetic patients report symptoms of incomplete defecation. We aimed to clarify the recto-anal manometric characteristics related to these symptoms. MATERIAL AND METHODS: A questionnaire regarding gastrointestinal symptoms was distributed to 35 diabetics (19 women and 16 men) aged between 39 and 81 years. Nineteen reported incomplete defecation sensation (WS) and 16 did not (NS). Recto-anal manometry was performed for all patients. Data are presented as mean±SD. RESULTS: Resting rectal pressure was 14.4±10.1 mmHg and 8.8±3.9 mmHg, p<.03; first sensation was 61.0±27.8 ml and 83.1±35.7 ml, p<.04; and maximum tolerable volume was 174.2±81.5 ml and 235.0±89.5 ml, p<.04 for WS and NS, respectively. The WS group was further divided into 2 groups according to symptom severity (less severe and very severe). Significant differences were found in resting external anal sphincter pressure (50.4±15.6 and 34.3±17.4, p<.04) and the recto anal inhibitory reflex (48.6±19.8 and 26.3±23.2, p<.03) between the less severe and very severe groups, respectively. CONCLUSIONS: (1) Resting rectal pressure was significantly higher in symptomatic individuals. (2) First sensation and maximum tolerable volume were higher in asymptomatic diabetics. (3) In diabetics with more severe symptoms, the resting external anal sphincter pressures were significantly lower. (4) The degree of relaxation in the recto-anal inhibitory reflex was significantly higher in individuals without complaints.
Subject(s)
Anal Canal/physiopathology , Diabetes Mellitus, Type 2/complications , Rectal Diseases/physiopathology , Rectum/physiopathology , Adult , Aged , Aged, 80 and over , Anal Canal/innervation , Defecation , Diabetes Mellitus, Type 2/physiopathology , Dilatation, Pathologic/etiology , Female , Follow-Up Studies , Humans , Male , Manometry , Middle Aged , Muscle Relaxation , Pressure , Rectal Diseases/complications , Rectum/innervation , Reflex, Abnormal , Sensation Disorders/etiology , Severity of Illness IndexABSTRACT
AIMS: The aim of this study was to compare esophageal motor characteristics between diabetics and healthy individuals. METHODS: Esophageal manometry was performed in 34 type 2 diabetics and 32 healthy individuals. Waves were evaluated in the 3 thirds of the esophagus (P1=upper, P2=middle, and P3=distal). RESULTS: In diabetics vs. controls, wave distribution was as follows: peristaltic waves, 83.5 ± 22.2% vs. 96.3 ± 4.4%, p<0.002; simultaneous waves, 3.26 ± 5.8% vs. 0.53 ± 1.3%, p<0.01; no transmitted waves, 10.62 ± 20.7% vs. 2.75 ± 3.0%, p<0.002; and retrograde waves, 2.68 ± 4.0% vs. 0.31 ± 1.1%, p<0.03. Wave amplitude was similar between groups. Average upstroke (mmHg/s) in diabetics vs. non-diabetics was P2, 33.8 ± 13.9 vs. 40.2 ± 17.7, p<0.03; and P3, 29.8 ± 15.3 vs. 41.3 ± 14.0, p<0.002. CONCLUSIONS: (1) Simultaneous waves, no transmitted waves, and retrograde esophageal waves were significantly more frequent in diabetics. (2) Average upstroke was significantly lower within the middle and distal esophagus of diabetic individuals. (3) Wave amplitude was similar in both groups.
