Characteristics And Influencing Factors Of Anorectal Pressure Measurement In Patients With Diabetic Constipation

Objective To investigate the anorectal dyskinesia and its influenceing factors in patients with diabetes mellitus and constipation,so as to guide clinical treatment.Methods The Solar GI gastrointestinal dynamic examination system produced by MMS company in Netherlands MMS was used to observe 57 patients with type 2diabetes constipation and simple diabetes mellitus who wre included according to the diagnostic criteria.At the same time,the patients were divided into 30 patients with type 2 diabetes constipation(group I),27 paients with simple diabetes(group II),and 28 petients with control group(group III).All patients were performed and the sensory function and the anal-rectal pressure,at the same time do a colonoscopy and except the anus dre check colorectal implement qualitative sex pathological change.To observed indicators(1)ARP and MASP;(2)indicators of rectal sensory function :initial rectal sensory threshold,initial defecation threshold,and maximum rectal tolerance;(3)data of the patients were recorded at the same time,inclcding general information : gender,age,BMI,drinking status,sleep status,and exercise habit;Clinical symptoms include: abdominal pain,abdominal distension,defecation effort,defecation feeling.SPSS 19.0 statistical software was used to analyze and process all the data.Results1.A total of 57 patients in the observation group were aged from 35?75 years old,with an average age of 58.9 ± 10.8years old.30 patients in the group I,including 16 males and 14 females,with an average age of 59.6 ± 10.7years old.There were 27 patients in the group II,including 14 males and 13 females,with an average age of 58.2±11.0years old.Group III included 28 patients(19males and9females),ranging from 38-72 years old,with an average age of 56.9±8.9 years old.There was no significant difference in gender,age and BMI between the three groups(p>0.05).2.There was no significant difference in the incidence of somking,drinking and physical exercise between group I and group II(p > 0.05).The incidence of sleep disorders in group I was higher than that in group II(63.3 VS 20.0),which was statistically significant(p<0.05).3.Patients in group I were divided into groups according to different factors,and it was suggested after anorectal pressure test that,in comparison with the rectal pressure test,MASP in the males was higher than that in females,and the difference was statistically significant(p < 0.05).The MASP level in the group with diabetic constipation anddefecation insufficiency was higher than that in the group without constipation insufficiency,and the difference was statistically significant(p <0.05).However,there was no significant difference in MASP between the combined symptom group(abdominal pain,abdominal distension,and strenuous defecation)and the group without symptoms(p>0.05).Meanwhile,there was no significant difference in ARP between the combined symptoms group and the non-combined symptoms group(p>0.05).There was no significant difference in ARP between the two groups(p>0.05).4.In this experiment,patients in group I were divided into groups according to different factors,and it was suggested after anorectal pressure test that the first defecation threshold and the maximum rectal tolerance volume in the group of diabetic insufficiency were increased in comparison of the measurement of rectal preception function,which was statistically significant(p<0.05).Howere the diabetic constipation group with abdominal pain,abdominal distension,defecation exertion and gender difference showed no statistical significance in the measurement of rectal sensory function(p>0.05).5.The anorectal pressure was measured in each group,and the results indicated that sensory threshold,the first defecation threshold and the maximun rectal tolerance in the group I was statistically significant(p<0.05)compared with that in group IIand III,While the comparison between group IIand IIIwas not statistically significant(p>0.05).The decrease of ARP in group I was compared with that in group II andIII,which was statistically significant(p<0.05);While the comparison between group II and III was not statistically significant(p>0.05).Conclusion1.The main characteristic of anorectal pressure measurement in patients with diabetes and constipation is the decline of rectal senory function.2.Clinical symptoms of constipation :defecation insufficiency may aggravate the decline of rectal perception,thus further aggravating the clinical symptoms of patients with diabetes and constipation.3.Diabetic constipation may be related to sleep status.