[Does manometric megarectum have a symptomatic role in patients complaining of dyschezia?]. / Le mégarectum manométrique a-t-il une responsabilité symptomatique chez les patients se plaignant d'une dyschésie?

ABSTRACT

UNLABELLED Adults with dyschezia are occasionally diagnosed as having megarectum when anorectal manometry identifies rectal sensory disturbances. It remains difficult however to ascertain whether this state represents a part of the pathophysiological process responsible for symptoms, or just an associated phenomenon. The aim of this study was to highlight the symptomatic and functional features encountered in patients with dyschezia and megarectum, and to compare them with those obtained in an asymptomatic group and in a group of patients complaining of dyschezia without manometric megarectum. PATIENTS AND METHODS: The maximum tolerable volume (MTV) was defined as the highest tolerable volume which induced painful and irrepressible repletion upon inflation of the rectum with air. The upper normal range of MTV (330 mL) was obtained from rectal manometry performed in a group of 18 healthy volunteers and asymptomatic patients (mean age 37.8 +/- 14 years, 12 F, 6 M). Between February 90 and February 92, 27 consecutive adults (48 ans +/- 15 years, 26 F, 1 M) suffering from dyschezia were found to have abnormally increased MTV, and were compared to a group of 35 patients (47 +/- 15.3 years, 34 F, 1 M) with dyschezia with MTV within normal ranges. Symptomatic patients underwent detailed interrogation, clinical examination, anorectal manometry, and evacuation proctography. RESULTS: Parity, prevalence of hysterectomy, symptoms and natural history did not differ between the two groups except for increased use of antidepressive agents in the megarectum group.(ABSTRACT TRUNCATED AT 250 WORDS)