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. 1988 Jan;29(1):5–9. doi: 10.1136/gut.29.1.5

Combined sensory and motor deficit in primary neuropathic faecal incontinence.

J Rogers 1, M M Henry 1, J J Misiewicz 1
PMCID: PMC1433255  PMID: 3343013

Abstract

Eleven patients with idiopathic faecal incontinence (IFI) and nine normal controls were studied with techniques of mucosal electrosensitivity and rectal distention for the quantitative assessment of anal and rectal sensation and with manometric and electromyographic tests for the assessment of anorectal motor function. The tests of motor function showed pelvic floor motor neuropathy in the patients with IFI, compared with controls, anal canal resting and voluntary contraction pressures were significantly (p less than 0.05, p less than 0.002) lower, pudendal nerve terminal motor latency and external anal sphincter fibre density were significantly (p less than 0.05, p less than 0.05) raised. The results of mucosal electrosensitivity (MES) disclosed a sensory deficit in the anal canal in patients with IFI, compared with controls, MES threshold was significantly (p less than 0.002) higher. Sensory thresholds to rectal distension were similar in the two groups. This study shows that sensory deficit of the anal canal occurs in combination with the motor neuropathy of the anal canal musculature in primary neuropathic faecal incontinence.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. DUTHIE H. L., GAIRNS F. W. Sensory nerve-endings and sensation in the anal region of man. Br J Surg. 1960 May;47:585–595. doi: 10.1002/bjs.18004720602. [DOI] [PubMed] [Google Scholar]
  2. Duthie H. L., Bennett R. C. The relation of sensation in the anal canal to the functional anal sphincter: a possible factor in anal continence. Gut. 1963 Jun;4(2):179–182. doi: 10.1136/gut.4.2.179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. 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]
  4. Gunterberg B., Kewenter J., Petersén I., Stener B. Anorectal function after major resections of the sacrum with bilateral or unilateral sacrifice of sacral nerves. Br J Surg. 1976 Jul;63(7):546–554. doi: 10.1002/bjs.1800630713. [DOI] [PubMed] [Google Scholar]
  5. Kiff E. S., Swash M. Slowed conduction in the pudendal nerves in idiopathic (neurogenic) faecal incontinence. Br J Surg. 1984 Aug;71(8):614–616. doi: 10.1002/bjs.1800710817. [DOI] [PubMed] [Google Scholar]
  6. Lane R. H., Parks A. G. Function of the anal sphincters following colo-anal anastomosis. Br J Surg. 1977 Aug;64(8):596–599. doi: 10.1002/bjs.1800640820. [DOI] [PubMed] [Google Scholar]
  7. Neill M. E., Swash M. Increased motor unit fibre density in the external anal sphincter muscle in ano-rectal incontinence: a single fibre EMG study. J Neurol Neurosurg Psychiatry. 1980 Apr;43(4):343–347. doi: 10.1136/jnnp.43.4.343. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Read M. G., Read N. W. Role of anorectal sensation in preserving continence. Gut. 1982 Apr;23(4):345–347. doi: 10.1136/gut.23.4.345. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Roe A. M., Bartolo D. C., Mortensen N. J. New method for assessment of anal sensation in various anorectal disorders. Br J Surg. 1986 Apr;73(4):310–312. doi: 10.1002/bjs.1800730421. [DOI] [PubMed] [Google Scholar]
  10. Shouler P., Keighley M. R. Changes in colorectal function in severe idiopathic chronic constipation. Gastroenterology. 1986 Feb;90(2):414–420. doi: 10.1016/0016-5085(86)90941-8. [DOI] [PubMed] [Google Scholar]
  11. Stålberg E., Thiele B. Motor unit fibre density in the extensor digitorum communis muscle. Single fibre electromyographic study in normal subjects at different ages. J Neurol Neurosurg Psychiatry. 1975 Sep;38(9):874–880. doi: 10.1136/jnnp.38.9.874. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Wald A., Tunuguntla A. K. Anorectal sensorimotor dysfunction in fecal incontinence and diabetes mellitus. Modification with biofeedback therapy. N Engl J Med. 1984 May 17;310(20):1282–1287. doi: 10.1056/NEJM198405173102003. [DOI] [PubMed] [Google Scholar]

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