Research Article
Volume 9 Issue 2 - 2021
Cortical Processing of Tonic Ano-Rectal Distensions in Patients with Idiopathic Faecal Incontinence
Rasmus Bach Nedergaard1,2,3, Susanne Haas3,4, Peter Christensen3,5, Klaus Krogh3,6, Søren Laurberg3,7, Christina Brock1,2 and Asbjørn Mohr Drewes1,2,3*
1Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
2Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
3Danish Cancer Society Centre for Research and Late Adverse Effects After Cancer in the Pelvic Organs, Aarhus and Aalborg University Hospitals, Aalborg, Denmark
4Department of Surgery, Aarhus University Hospital, Denmark
5Pelvic Floor Unit, Department of Surgery, Aarhus University Hospital, Aarhus N, Denmark
6Neurogastroenterology Unit, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
7Department of Surgery, Section of Coloproctology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
*Corresponding Author: Asbjørn Mohr Drewes, Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
Received: December 07, 2021; Published: January 28, 2022




Abstract

Aim: The purpose of this study was to investigate the ano-rectal cerebral axis in patients with idiopathic fecal incontinence during sustained distensions in the rectum and in the anal canal.

Methods: 20 women with idiopathic fecal incontinence and 20 healthy age matched women were included. Ano-rectal function was assessed using standard anal manometry together with the sensory response to tonic ano-rectal distension. Cortical electroencephalographic signals were recorded at rest and during 1 minute sustained balloon distension at the urge to defecate threshold in both the anal canal and rectum. Spectral power analysis of the signal during the distension was computed with wavelet analysis, and the coefficients were divided into predefined frequency bands: delta (1 - 4Hz), theta (4 - 8Hz), alpha (8 - 12Hz), beta (12 - 32Hz) and gamma (32 - 70Hz). 

Results: Compared to controls, idiopathic fecal incontinence patients had lower anal resting- (- 48 cm H2O, p < 0.001) and squeeze-pressures (-103 cm H2O, p < 0.001). Further, idiopathic fecal incontinence patients had lower thresholds for first sensation of urge (- 36 ml, p = 0.005) and tolerated decreased maximum volume in rectum (- 89 ml, p = 0.002). There were no differences between idiopathic fecal incontinence patients and healthy controls in any spectral recordings, neither at rest or during ano-rectal distensions. 

Conclusion: In this study patients with idiopathic fecal incontinence and healthy controls exhibited similar cortical processing at rest and during sustained balloon distension of the ano-rectum, decreased sensory threshold to maximum tolerable volume in the rectum for the idiopathic fecal incontinence patients.

 

Keywords: Electroencephalography, Manometry, Sustained Distension, Wavelet-Analysis

References

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Citation: Asbjørn Mohr Drewes., et al. “Cortical Processing of Tonic Ano-Rectal Distensions in Patients with Idiopathic Faecal Incontinence”. EC Gastroenterology and Digestive System 9.2 (2021): 08-13.

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