Table 3.
Proportions of patients with abnormal findings on anorectal physiological testing in patients with faecal incontinence in isolation, functional constipation in isolation and coexistent faecal incontinence and functional constipation, defined by the Rome IV core criteria, in those with a minimum of anorectal manometry, rectal sensation testing and endoanal ultrasonography (n = 3697; 91·9% of the total study sample).
| Faecal incontinence N = 750 (20·3%) | Functional constipation N = 1438 (38·9%) | Coexistent symptoms N = 1509 (40·8%) | P-value | |
|---|---|---|---|---|
| Anorectal manometry1 (%) Normal Anal hypotension + normal contractility Anal normotension + hypocontractility Anal hypotension + hypocontractility |
321 (42·8) 86 (11·5) 183 (24·4) 160 (21·3) |
962 (66·9) 88 (6·1) 296 (20·6) 92 (6·4) |
676 (44·8) 177 (11·7) 385 (25·5) 271 (18·0) |
< 0·0001a,c < 0·0001a,c 0·005c < 0·0001a,c |
| Endoanal ultrasonography (%) Internal anal sphincter Intact Degenerate/atrophic Disrupted Abnormal, focal External anal sphincter Intact Degenerate/atrophic Disrupted Abnormal, focal |
382 (50·9) 187 (24·9) 170 (22·7) 49 (6·5) 345 (46·0) 65 (8·7) 272 (36·3) 98 (13·1) |
1114 (77·5) 173 (12·0) 104 (7·2) 74 (5·1) 945 (65·7) 57 (4·0) 257 (17·9) 198 (13·8) |
892 (59·1) 323 (21·4) 267 (17·6) 94 (6·2) 774 (51·3) 139 (9·2) 456 (30·2) 201 (13·3) |
< 0·0001a,b,c < 0·0001a,c < 0·0001a,b,c 0·314 < 0·0001a,c < 0·0001a,c < 0·0001a,b,c 0·886 |
| Rectal sensation to balloon distension1 (%) Normal Rectal hypersensitivity Rectal hyposensitivity |
620 (82·7) 61 (8·1) 69 (9·2) |
1164 (80·9) 57 (4·0) 217 (15·1) |
1252 (83·0) 72 (4·8) 185 (12·3) |
0·326 0·0001a,b 0·0004a |
| Whole-gut transit studies (%) Delayed |
81 (10·8) 17 (21·0) |
851 (59·2) 376 (44·2) |
510 (33·8) 165 (32·4) |
-d -d |
| Defaecography (%) Functional abnormality Significant structural abnormality Intussusception Obstructing recto-rectal Recto-anal Rectocoele Depth ≥4 cm Depth 2–4 cm, symptomatic Enterocoele Megarectum Rectal prolapse Functional + structural abnormality |
616 (82·1) 138 (22·4) 230 (37·3) 78 (12·7) 110 (17·9) 60 (9·7) 5 (0·8) 12 (1·9) 29/202 (14·4) 10 (1·6) 29 (4·7) |
1378 (95·8) 380 (27·6) 856 (62·1) 175 (12·7) 274 (19·9) 285 (20·7) 259 (18·8) 132 (9·6) 125/677 (18·5) 16 (1·2) 168 (12·2) |
1392 (92·2) 338 (24·2) 743 (53·4) 153 (11·0) 243 (17·5) 199 (14·3) 178 (12·8) 87 (6·3) 87/626 (13·9) 56 (4·0) 131 (9·4) |
< 0·0001a,b,c 0·026 < 0·0001a,b,c 0·327 0·232 < 0·0001a,b,c < 0·0001a,b,c < 0·0001a,b,c 0·063 < 0·0001b,c < 0·0001a,b |
Legend:
Diagnostic classification based on the London classification for disorders of anorectal function.
Post hoc test: significant difference (p < 0·01) between faecal incontinence and functional constipation group.
Post hoc test: significant difference (p < 0·01) between faecal incontinence and coexistence group.
Post hoc test: significant difference (p < 0·01) between functional constipation and coexistence group.
Analysis not performed due to evident selection bias.