Official websites use. Share sensitive information only on official, secure websites. All had normal anal resting and squeeze pressures. Alterations in rectal sensation were frequently seen, more commonly with rectal hyposensitivity. Trial registration: ClinicalTrials. It can be associated with pain, discharge, faecal incontinence, and sexual and psychological impairment [ 1 ]. A higher prevalence is seen with increasing disease duration and is related to disease location [ 2 ].
Anorectal manometry is the best technique for evaluation of anal sphincter pressures. It also allows for an evaluation of rectoanal coordination during simulated defecation [ 4 ]. High-resolution-anorectal manometry HR-ARM allows greater detail and resolution of the anorectal pressure change compared with conventional techniques [ 5 ].
There are few studies evaluating anorectal function in patients with inflammatory bowel disease IBD. Most studies have used conventional manometry, and conclusions are limited by the inclusion of a heterogeneous cohort [ 6 , 7 ] of symptomatic patients with diverse indications for anorectal evaluation, active disease vs.
Many studies have not included patients with perianal CD [ 8 , 10 ] or have only studied a small number of patients [ 11 , 12 ]. Other studies [ 6 , 7 , 9 ], with larger heterogeneous samples of IBD patients with active perianal disease, have not reported anorectal function according to perianal CD. Patients may be at risk of poor anorectal function due to excessive tissue damage. Surgical treatment of perianal CD has the potential to compromise anal sphincter structure, which may predispose to subsequent faecal incontinence.
The presence of symptoms associated with anorectal dysfunction, such as faecal incontinence, can sometimes poorly correlate with the presence of anal sphincter abnormalities, as shown in patients with obstetric anal sphincter injuries [ 14 ]. Moreover, even in patients without symptoms, the presence of anal sphincter abnormalities may have important implications for the future selection of the type of delivery [ 15 ] and might even pose a contra-indication for certain types of anorectal surgeries [ 16 ].
