ULCERATIVE-COLITIS - RECTAL DILATIONS IN A PATIENT WITH REFRACTORY DIARRHEA - REPORT OF A CASE

A 45-year-old man with an eight-year history of ulcerative colitis was evaluated for severe, nonbloody diarrhea. Symptoms, which began two y ears earlier, were characterized by 15 bowel movements per day, accomp anied by urgency and incontinence, A reduced rectal compliance was mea sured at manometry. All conventional treatments were not able to modif y the symptoms despite improvement of inflammatory colonic lesions. PU RPOSE: The aim was to reduce bowel movements and incontinence by incre asing rectal compliance. METHODS: Gradual pneumatic dilations of the r ectum were performed three times per week for three weeks. RESULTS: Th e patient's diarrhea improved dramatically, decreasing in frequency fr om approximately 15 to only 3 bowel movements per day, while contempor aneously increasing rectal compliance. Such effect, still evident 15 m onths after discontinuation of dilation, was probably obtained by impr ovement of viscoelastic features of the intestinal wall. CONCLUSIONS: Rectal pneumatic dilation may be a successful attempt in some forms of intractable diarrhea in long-lasting ulcerative colitis.