Anismus as a cause of functional constipation – Experience from Serbia

Igor Dušan Jovanović; Dragana Jovanović; Milenko Uglješić; Nikola Milinić; Mirjana Cvetković; Marija Branković; Goran Nikolić

doi:10.2298/2589

Igor Dušan Jovanović Clinical Hospital Center “Bežanijska kosa”, Belgrade, Serbia
Dragana Jovanović Clinical Hospital Center “Bežanijska kosa”, Belgrade, Serbia
Milenko Uglješić Clinical Center of Serbia, Belgrade, Serbia
Nikola Milinić Clinical Hospital Center “Bežanijska kosa”, Belgrade, Serbia.
Mirjana Cvetković Clinical Hospital Center “Bežanijska kosa”, Belgrade, Serbia.
Marija Branković Clinical Hospital Center “Bežanijska kosa”, Belgrade, Serbia.
Goran Nikolić Clinical Hospital Center “Bežanijska kosa”, Belgrade, Serbia.

DOI: https://doi.org/10.2298/2589

Keywords: constipation, manometry, risk factors, serbia,

Abstract

Backround/Aim. Anismus is paradoxal pressure increase or pressure decrease less than 20% of external anal sphincter during defecation straining. This study analyzed the presence of anismus as within a group of patients with the positive Rome III criteria for functional constipation. We used anorectal manometry as the determination method for anismus. Methods. We used anorectal water-perfused manometry in 60 patients with obstructive defecation defined by the Rome III criteria for functional constipation. We also analyzed anorectal function in 30 healthy subjects. Results. The presence of anismus is more frequent in the group of patients with obstructive defecation compared to the control group (a highly statistically significant difference, p < 0.01). Furthermore, we found that the Rome III criteria for functional constipation showed 90% accuracy in predicting obstructive defecation. We analyzed the correlation of anismus with the presence of weak external anal sphincter, rectal sensibility disorders, enlarged piles, diverticular disease and anatomic variations of colon. We found no correlation between them in any of these cases. Conclusion. There is a significant correlation between anismus and positive Rome III criteria for functional constipation. Anorectal manometry should be performed in all patients with the positive Rome III criteria for functional constipation.

Author Biography

Igor Dušan Jovanović, Clinical Hospital Center “Bežanijska kosa”, Belgrade, Serbia

Gastroenetrology Department

Head of GI functional testing unit

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