TY - JOUR
T1 - Anorectal manometry in the assessment of anorectal function in Parkinson's disease
T2 - A comparison with chronic idiopathic constipation
AU - Ashraf, Waseem
AU - Pfeiffer, Ronald F.
AU - Quigley, Eamonn Martin
PY - 1994/1/1
Y1 - 1994/1/1
N2 - We investigated the role of anorectal manometry in evaluating constipation and anorectal function in 15 patients with Parkinson's disease (PD) and compared results with those of 9 patients with idiopathic constipation (IC) and 8 control (C) subjects. Anal sphincter pressures on voluntary squeeze were lower in the PD patients. Sustained squeeze pressures (mm Hg C versus IC versus PD: 46.8 ± 5.2 versus 31.2 ± 3.6 versus 26.6 ± 3.9; p < 0.05 PD versus C), squeeze duration (seconds: 53.6 ± 2.5 versus 48.5 ± 4.1 versus 33.6 ± 9; p < 0.05 PD versus C) and squeeze index (area under the squeeze curve: 44.0 ± 2.9 versus 34.5 ± 3.3 versus 21.4 ± 2.9; p < 0.001 PD versus C) were significantly lower in the PD group in comparison to the control group. In contrast, none of the parameters of anorectal manometry differed between controls and patients with idiopathic constipation. Some Parkinson's disease patients demonstrated an abnormal, hypercontractile response on testing of the rectoanal inhibitory reflex. Anal sphincter length, basal sphincter pressures, maximal squeeze pressures, extent of relaxation on rectoanal inhibitory reflex and threshold volume for rectal sensation were similar in the three groups. We conclude that an impaired squeeze response is a specific feature of anorectal function in Parkinson's disease. This may indicate direct involvement of the pelvic floor musculature by the parkinsonian disease process.
AB - We investigated the role of anorectal manometry in evaluating constipation and anorectal function in 15 patients with Parkinson's disease (PD) and compared results with those of 9 patients with idiopathic constipation (IC) and 8 control (C) subjects. Anal sphincter pressures on voluntary squeeze were lower in the PD patients. Sustained squeeze pressures (mm Hg C versus IC versus PD: 46.8 ± 5.2 versus 31.2 ± 3.6 versus 26.6 ± 3.9; p < 0.05 PD versus C), squeeze duration (seconds: 53.6 ± 2.5 versus 48.5 ± 4.1 versus 33.6 ± 9; p < 0.05 PD versus C) and squeeze index (area under the squeeze curve: 44.0 ± 2.9 versus 34.5 ± 3.3 versus 21.4 ± 2.9; p < 0.001 PD versus C) were significantly lower in the PD group in comparison to the control group. In contrast, none of the parameters of anorectal manometry differed between controls and patients with idiopathic constipation. Some Parkinson's disease patients demonstrated an abnormal, hypercontractile response on testing of the rectoanal inhibitory reflex. Anal sphincter length, basal sphincter pressures, maximal squeeze pressures, extent of relaxation on rectoanal inhibitory reflex and threshold volume for rectal sensation were similar in the three groups. We conclude that an impaired squeeze response is a specific feature of anorectal function in Parkinson's disease. This may indicate direct involvement of the pelvic floor musculature by the parkinsonian disease process.
KW - Anorectal function
KW - Anorectal manometry
KW - Idiopathic constipation
KW - Parkinson's disease
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U2 - 10.1002/mds.870090612
DO - 10.1002/mds.870090612
M3 - Article
C2 - 7845407
AN - SCOPUS:0028019455
VL - 9
SP - 655
EP - 663
JO - Movement Disorders
JF - Movement Disorders
SN - 0885-3185
IS - 6
ER -