EVALUATION OF ABILITY TO DEFECATE USING SALINE EVACUATION FROM THE RECTUM

PURPOSE: The purpose of this study is to establish a simple technique to evaluate anorectal motility and the dynamics of defecation. METHODS : Pressure fluctuations in the rectum and anal canal during 500 ml of saline infusion in the rectum and then a saline evacuation curve were recorded using manometer and uroflowmeter. RESULTS: This study consist ed of 37 patients with a mean age of 49.6 years. All patients without problems with defecation showed periodic relaxation of the anal canal, which was synchronized with rectal contractions during saline infusio n. The saline evacuation curves of these patients were characterized b y short evacuation time and high-peak flow. Of the 13 patients with co nstipation, 9 showed no rectoanal synchronization and had segmental ev acuation curves. The patients with incontinence tended to have poor ab ility for holding saline in the rectum, resulting in low-peaked evacua tion curves. CONCLUSIONS: This simple and noninvasive technique for re cording anorectal pressure fluctuations and dynamics of saline evacuat ion from the rectum enables quantitative and qualitative evaluation of the ability to defecate.