Abstract
Anorectal function has been assessed in 53 patients with Crohn's disease by measurement of resting and squeeze anal canal pressures and the maximum volume tolerated during distension of a balloon in the rectum. Radiographs of the rectum from barium enema examination were also reviewed to assess rectal capacity. Thirty-three patients have had a colectomy and ileorectal anastomosis for Crohn's colitis of whom 13 now have a stoma because they either required a protectomy (n=9) or where closure of a loop ileostomy had not been possible (n=4) because of severe anorectal disease. The maximum tolerated volume was less than 150 ml in 12 of 13 patients who now have a stoma compared with none of the 20 patients who have a functioning anastomosis. Although the correlation between a radiological assessment of rectal capacity and the maximum tolerated volume was poor, a severely contracted rectum was associated with the need for a stoma in six of seven patients compared with only two of 13 patients who did not have radiological signs of a narrow rectum.
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Selected References
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- Alexander-Williams J., Buchmann P. Perianal Crohn's disease. World J Surg. 1980;4(2):203–208. doi: 10.1007/BF02393577. [DOI] [PubMed] [Google Scholar]
- Arabi Y., Alexander-Williams J., Keighley M. R. Anal pressures in hemorrhoids and anal fissure. Am J Surg. 1977 Nov;134(5):608–610. doi: 10.1016/0002-9610(77)90445-7. [DOI] [PubMed] [Google Scholar]
- Buchmann P., Mogg G. A., Alexander-Williams J., Allan R. N., Keighley M. R. Relationship of proctitis and rectal capacity in Crohn's disease. Gut. 1980 Feb;21(2):137–140. doi: 10.1136/gut.21.2.137. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Buchmann P., Weterman I. T., Keighley M. R., Peña S. A., Allan R. N., Alexander-Williams J. The prognosis of ileorectal anastomosis in Crohn's disease. Br J Surg. 1981 Jan;68(1):7–10. doi: 10.1002/bjs.1800680103. [DOI] [PubMed] [Google Scholar]
- Duthie H. L. Progress report. Anal continence. Gut. 1971 Oct;12(10):844–852. doi: 10.1136/gut.12.10.844. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Farthing M. J., Lennard-jones J. E. Sensibility of the rectum to distension and the anorectal distension reflex in ulcerative colitis. Gut. 1978 Jan;19(1):64–69. doi: 10.1136/gut.19.1.64. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Glotzer D. J., Gardner R. C., Goldman H., Hinrichs H. R., Rosen H., Zetzel L. Comparative features and course of ulcerative and granulomatous colitis. N Engl J Med. 1970 Mar 12;282(11):582–587. doi: 10.1056/NEJM197003122821102. [DOI] [PubMed] [Google Scholar]
- Goligher J. C. The outcome of excisional operations for primary and recurrent Crohn's disease of the large intestine. Surg Gynecol Obstet. 1979 Jan;148(1):1–8. [PubMed] [Google Scholar]
- Greenstein A. J., Sachar D. B., Pasternack B. S., Janowitz H. D. Reoperation and recurrence in Crohn's colitis and ileocolitis Crude and cumulative rates. N Engl J Med. 1975 Oct 2;293(14):685–690. doi: 10.1056/NEJM197510022931403. [DOI] [PubMed] [Google Scholar]
- LOCKHART-MUMMERY H. E., MORSON B. C. Crohn's disease (regional enteritis) of the large intestine and its distinction from ulcerative colitis. Gut. 1960 Jun;1:87–105. doi: 10.1136/gut.1.2.87. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nugent F. W., Veidenheimer M. C., Meissner W. A., Haggitt R. C. Prognosis after colonic resection for Crohn's disease of the colon. Gastroenterology. 1973 Sep;65(3):398–402. [PubMed] [Google Scholar]
- Steinberg D. M., Allan R. N., Cooke W. T., Alexander-Williams J. The place of ileorectal anastomosis in Crohn's disease. Aust N Z J Surg. 1976 Feb;46(1):49–54. doi: 10.1111/j.1445-2197.1976.tb03193.x. [DOI] [PubMed] [Google Scholar]
- Weterman I. T., Peña A. S. The long-term prognosis of ileorectal anastomosis and proctocolectomy in Crohn's disease. Scand J Gastroenterol. 1976;11(2):185–191. [PubMed] [Google Scholar]