Detection of individual motor units of the puborectalis muscle by non-invasive EMG electrode arrays.

Purpose: The purpose of the study was to demonstrate that anatomical features of individual motor units of the puborectalis muscle can be detected with non-invasive electromyography (EMG) and to evaluate differences in electrophysiological properties of the puborectalis muscles in a small group of healthy and pathologic subjects.

Methods: Multichannel EMG was recorded by means of a flexible probe applied on the gloved index finger and carrying an array of eight equally spaced (1.15 mm) electrodes.

Responses of anal constipation to biofeedback treatment.

Objective: Biofeedback is considered an effective treatment for anal constipation, but a substantial proportion of patients fail to improve. Our aim was to identify the key predictors of outcome using a comprehensive standardized evaluation of anorectal function.

Material And Methods: We retrospectively analysed the clinical and physiological data of 148 patients consecutively treated for constipation due to functional outlet obstruction by biofeedback.

Predictors of response to biofeedback treatment in anal incontinence.

Purpose: Biofeedback is considered an effective treatment for anal incontinence, but a substantial proportion of patients fails to improve. The purpose of this study was to identify the key predictors of outcome.

Methods: We retrospectively analyzed the clinical and physiologic data of 145 patients consecutively treated in our unit for anal incontinence by biofeedback.

Significance of pelvic floor muscles in anal incontinence.

Background & Aims: The pathophysiology of anal incontinence may be elusive using current parameters. Our aim was to establish the role of the levator ani in anal continence.

Methods: In 53 patients with anal incontinence, 30 with constipation as disease controls, and 15 healthy controls, we evaluated incontinence severity by a 0-12 scale, anorectal function by standard manometric tests, and levator ani contraction by a perineal dynamometer.

Nausea and Vomiting.

Nausea and vomiting are rather stereotyped symptoms. The challenge is that nausea and vomiting have many different causes and, in some patients, management may be rather complex. The clue is to determine the causal factor early.