Anorectal function in the solitary rectal ulcer syndrome |
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Authors: | Nigel R Womack FRCS Professor Norman S Williams MS John H Holmfield Mist John F Morrison Phd |
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Affiliation: | (1) The General Infirmary at Leeds, the University Department of Surgery, Leeds, England;(2) the Department of Physiology, The University of Leeds, Leed, England;(3) Surgical Unit, The London Hospital, Whitechapel, El 1BB London, England |
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Abstract: | The anorectal function of nine patients with solitary rectal ulcer syndrome (SRUS) (5 F: 4 M, median age, 27 (range, 19–41
years) and nine control subjects (5 F: 4 M, median age, 47 (35–66)P<0.01) has been investigated by a new technique that radiologically visualizes the anorectum during voiding of a semisolid
contrast medium, while simultaneously measuring intrarectal pressure and anal sphincter EMG activity. A degree of rectal prolapse
was demonstrated in eight of the SRUS patients; six of these lesions were clinically occult. Abnormal failure of the anal
sphincter to relax on voiding was present in seven of the SRUS patients. These abnormalities resulted in the SRUS patients
requiring a greater increase in intrarectal pressure (median, 100 cm water) to void than the control subjects (median, 65
cm water,P<0.01). This combination of high intrarectal pressure and rectal prolapse during straining seems to be the cause of SRUS
This work was supported by a grant from the Medical Research Council. |
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Keywords: | Solitary rectal ulcer syndrome Anorectal function Rectal prolapse Proctography |
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