Diferencias en las presiones del canal anal y la sensibilidad rectal en pacientes con incontinencia anal, estreñimiento crónico y sujetos sanos / No disponible

Introducción: Existe gran variabilidad en los hallazgos manométricos entre pacientes con incontinencia anal (IA) y sujetos sanos. La correlación entre las presiones del canal anal y la IA no es exacta por el amplio rango de valores normales. Objetivos: Estudio prospectivo para evaluar diferencias en las presiones del canal anal y en la sensibilidad rectal en pacientes con IA, estreñimiento crónico (EC) y sujetos sanos. Material y métodos: Noventa y cuatro pacientes con IA, 36 pacientes con EC y 15 sujetos sanos. Se obtuvieron: edad, sexo, presión de reposo, longitud del canal anal (LCA), presión de máxima contracción voluntaria (PMCV), duración de la contracción voluntaria, primera sensación, sensación de urgencia y máximo volumen tolerado (MVT). Estudio estadístico: test de Kruskal-Wallis, test de Mann-Whitney, regresión logística multinomial. Resultados: Se encontraron diferencias significativas en la edad (p < 0,001), la presión de reposo (p < 0,001), la LCA (p < 0,001) y la PMCV (p < 0,01) en el grupo de IA con respecto a los otros dos grupos. El volumen para la primera sensación fue significativamente más bajo en los sujetos sanos que en los otros dos grupos (p < 0,05). El volumen de urgencia y el MVT fueron menores en el grupo con IA con respecto a los otros dos grupos (p < 0,001). En el análisis multivariante la edad, la presión de reposo y el volumen de la primera sensación y de la urgencia aumentan el riesgo relativo de IA. Conclusiones: La mayor edad, la disminución presión basal del canal anal y la alteración del umbral sensorial rectal aumentan el riesgo de IA(AU)

Introduction: There exist a great variability in the manometric findings between patients with anal incontinence (AI) and healthy subjects. The correlation between the pressures of the anal canal and the AI is not exact by the wide rank of normal values. Objectives: Prospective study to evaluate differences in the pressures of the anal canal and in rectal sensitivity in patients with AI, chronic constipation (CC) and healthy subjects. Material and methods: Ninety four patients with AI, 36 patients with CC and 15 healthy subjects were included. The following data were obtained: age, sex, resting pressure, anal canal length (ACL), squeeze maximum pressure (SMP), squeeze pressure duration (SPD), first sensation, urge and maximum tolerated volume (MTV). Statistical study: test of Kruskal-Wallis, test of Mann-Whitney, and multinomial logistic regression test. Results: There were significant differences in the resting pressure (p < 0.001), the ACL (p < 0.001) and the SMP (p < 0.01) in the group of AI with respect to the other two groups. The volume for the first sensation was significantly lower in the healthy subjects than that in the other two groups (p < 0.05). The urge volume and the MVT were smaller in the group with AI with respect to the other groups (p < 0.001). In multivariate analysis the age, the resting pressure and the volume for the first sensation and urge increase the relative risk for AI. Conclusions: The greater age, the decrease in anal canal resting pressure and the alteration of rectal sensation increase the risk for AI(AU)

Differences in the pressures of canal anal and rectal sensitivity in patients with fecal incontinence, chronic constipation and healthy subjects.

INTRODUCTION: There exists a great variability in the manometric findings between patients with anal incontinence (AI) and healthy subjects. The correlation between the pressures of the anal canal and the AI is not exact by the wide rank of normal values. OBJECTIVES: Prospective study to evaluate differences in the pressures of the anal canal and in rectal sensitivity in patients with AI, chronic constipation (CC) and healthy subjects. MATERIAL AND METHODS: Ninety four patients with AI, 36 patients with CC and 15 healthy subjects were included. The following data were obtained: age, sex, resting pressure, anal canal length (ACL), squeeze maximum pressure (SMP), squeeze pressure duration (SPD), first sensation, urge and maximum tolerated volume (MTV). Statistical study: test of Kruskal-Wallis, test of Mann-Whitney, and multinomial logistic regression test. RESULTS: There were significant differences in the resting pressure (p < 0.001), the ACL (p < 0.001) and the SMP (p < 0.01) in the group of AI with respect to the other two groups. The volume for the first sensation was significantly lower in the healthy subjects than that in the other two groups (p < 0.05). The urge volume and the MVT were smaller in the group with AI with respect to the other groups (p < 0.001). In multivariate analysis the age, the resting pressure and the volume for the first sensation and urge increase the relative risk for AI. CONCLUSIONS: The greater age, the decrease in anal canal resting pressure and the alteration of rectal sensation increase the risk for AI.

Acalasia / No disponible

No disponible

Impedancia intraluminal multicanal asociada a pHmetría en el estudio de la enfermedad por reflujo gastroesofágico / Multichannel intraluminal impedance associated with pH-metry in the study of gastroesophageal reflux disease

No disponible

Alternativas terapéuticas en acalasia / Therapeutical alternatives in achalasia

No disponible

Normal values and influence of anthropometric and demographic factors on ambulatory cutaneous electrogastrography in healthy volunteers.

INTRODUCTION: Cutaneous Electrogastrography (EGGc) is a technique used for recording the Gastric Electrical Activity by means of electrodes placed on the abdominal skin. The aim of the present study was to determine normal values in healthy volunteers as well as the influence of factors such as age, gender, Body Mass Index (BMI) and echographic location of the gastric antrum. METHODS: An abdominal echography was initially performed in 35 of the 44 healthy volunteers in order to locate the gastric antrum and to place along its axis the skin electrodes, whereas in the other 9, the electrodes were placed according to anatomical references. Afterwards, the echography was also performed in those 9 volunteers in order to have all the 44 baseline echographic records. In every case, a record of ambulatory EGGc over 60 minutes was obtained, along with other record over the same period after eating a standard meal. The analysis of data was conducted through visual inspection and combined computer analysis. RESULTS: Eighty per cent of the study subjects showed a dominant frequency ranging from 2 to 4 cpm during both periods. After the meal, the parameters showed a characteristic variation. A significant difference was found when comparing subjects under 40 years of age versus subjects between 40 and 60 years of age in terms of preprandial dominant frequency instability coefficient (DFIC) (p = 0.002) and bradygastria (p = 0.03). Subjects with BMI < 25 kg/m2 showed preprandially a smaller dominant power instability coefficient (DPIC) (p = 0.035) and a greater Dominant Power (DP) (p = 0.045). In subjects without echographic control, DFIC (p = 0.001), bradygastria (p = 0.016) and tachygastria (p = 0.02) were more frequent, with a shorter period of normogastria (p = 0.001) during the postprandial period. CONCLUSIONS: Normogastria is the predominant rhythm in healthy people, although brief dysarrhythmias can be recorded that do not have any pathological meaning. Age and BMI, but not sex, seem to influence the Gastric Electrical Activity. The percentage of gastric dysarrhythmias decreases when the electrodes are placed along the longitudinal axis of the gastric antrum through echographic control.

Valores de normalidad e influencia de factores antropométricos y demográficos en electrogastrografía ambulatoria en voluntarios sanos / Normal values and influence of antropometric and demographic factors on ambulatory cutaneous electrogastrography in healthy volunteers

Introducción: la Electrogastrografía Cutánea (EGGc) es la técnica de registro de la Actividad Eléctrica Gástrica (AEG) por medio de electrodos colocados en la superficie cutánea abdominal. Se plantea determinar los valores de normalidad en voluntarios sanos y estimar cómo influyen factores como edad, sexo, índice de masa corporal (BMI) y localización ecográfica del antro gástrico. Métodos: se realizó ecografía abdominal inicialmente en 35 de los 44 voluntarios sanos para localizar antro gástrico y colocar sobre su eje los electrodos cutáneos, en otros 9 se colocaron según referencias anatómicas. Posteriormente la ecografía se realizó en esos 9 para tener los 44 registros con ecografía previa. En todos los casos se obtuvo un registro de EGGc ambulatoria de 60 minutos y otro tras una comida estándar de igual duración. El análisis de los datos se llevó a cabo por medio de inspección visual y análisis informático combinado. Resultados: el 80 por ciento de los sujetos estudiados mostraron una Frecuencia Dominante (FD) entre 2 y 4 cpm en ambos periodos. Tras la comida se produjo una variación característica de las variables. Al comparar sujetos menores de 40 años respecto a aquéllos entre 40 y 60 años hallamos diferencias en el Coeficiente de Inestabilidad de la Frecuencia Dominante (CIFD) (p=0,002) y bradigastria (p=0,03) preprandiales. Los sujetos con BMI <25 kg/m2 presentaron menor Coeficiente de Inestabilidad de la Potencia Dominante (CIPD) (p=0,035) y mayor Potencia Dominante (PD) (p=0,045) preprandial. Los sujetos sin control ecográfico mostraron mayor CIFD (p=0,001), bradigastria (p=0,016) y taquigastria (p=0,02) con menor normogastria (p=0,001) en periodo postprandial. Conclusiones: la normogastria es el ritmo predominante en sujetos sanos, aunque es posible registrar disritmias breves sin claro significado patológico. La edad y el BMI parecen influir en las características de la AEG registrada de forma cutánea, no lo hace el sexo. El porcentaje de disritmias gástricas es menor si los electrodos se sitúan en la proyección del eje longitudinal de antro gástrico mediante control ecográfico (AU)