Study On The Characteristics Of Anorectal Manometry In Patients With Different Gender,Age And Duration Of Functional Constipation

Objective:To study the similarities and differences of pathology and physiological mechanism of patients with different gender,age and duration of functional constipation(FC),and to explore the influences of gender,age and course on parameters of anorectal manometry,and to provide the basis for the next treatment.Methods:The 50 patients with FC and 20 healthy volunteers,were divided into the elderly group(?60 years old)and the non-elderly group(<60 years old)according to their age.They are in the Shanxi Jinching Da Yi Hospital from December 2013 to December 2016.The case group and control group were divided into male group and female group according to the gender.The patients were divided into short-course group(? 2 years)and long-course group(> 2 years)according to the course of the disease.Anorectal resting pressure,maximal squeezing pressure,first sensitive volume of rectum,defecation sensitive volume of rectum,defecation distress volume,the maximum tolerable volume of rectum and the minimum relaxation volume(MRV)of the rectoanal inhibitory reflex(RAIR)were measured by anorectal manometry,and the results of anorectal manometry were classified.Results:Compared with the control group,the maximum squeezing pressure of male FC patients,the four sensory thresholds of rectal and the MRV of RAIR were increased.In addition,the pelvic floor muscle disorder(type I and type ?)accounted for 65.38%,the lack of force(type ?)accounted for 30.77%,normal accounted for 3.85%.There was no significant difference between the anorectal resting pressure and the maximal squeezing pressure of the female FC patients.The first sensitive volume,the defecation sensitive volume and the MRV of the RAIR was increased,and the pelvic floor muscle disorder accounted for 58.33%,the lack of force accounted for 25%,normal accounted for 16.67%.There were significant differences in the defecation distress volume and maximum tolerable threshold of rectum in male and female patients.Compared with the control group,there was no difference in anorectal resting pressure and the maximal squeezing pressure between the elderly patients with FC,the four sensory thresholds of the rectum increased,the MRV of RAIR increased,and the pelvic floor muscle imbalance accounted for 41.67% Lack of force accounted for 45.83%,12.5% of the normal type.The first sensitive volume,maximum tolerance threshold and the MRV of RAIR of non-elderly patients with FC increased,and the remaining test indicators compared with the control group was not statistically significant.In the classification of pelvic floor muscle disorders accounted for 80.77%,less than 11.54% of the urinary driving force,the normal type accounted for 7.69%.Compared with the control group,the maximum squeezing pressure of FC short course group was decreased,and the MRV of RAIR increased,and the difference of four sensory thresholds was not statistically significant.Classification of pelvic floor muscle disorders accounted for 60%,defecation less than 32% of the driving force,the normal type accounted for 8%.There was no statistically significant difference between the anorectal resting pressure and the maximal squeezing pressure in the long course group,and the four sensory thresholds of the rectum increased,and the MRV of RAIR increased,72% of the pelvic floor muscle dysfunction was classified,Lack of force accounted for 16%,12% of normal type.Conclusion:The pathogenesis of FC patients includes rectal anal canal pressure abnormalities and changes in rectal sensitivity,rectal high tolerance in the male group is more obvious,pelvic floor muscle dysfunction and lack of bowel movements are involved in the incidence of male and female FC patients.Rectal hypo-sensitivity and high tolerance more obvious in non-elderly FC patients,non-elderly FC to pelvic floor muscle disorders,elderly FC patients in addition to pelvic floor muscle disorders,defecation is also an important factor in driving.Rectal hypoesthesia and high tolerance only involved in the long course of the pathogenesis of FC patients,short course of disease and long course of FC patients are pelvic floor muscle dyssynchronia,combined with inadequate bowel movement.Due to different gender,age and duration of FC patients rectal anal canal pressure indicators are similar,for its different pathogenesis to develop more effective treatment.