Systemic sclerosis and anorectal dysfunction: The Leeds experience.

J Scleroderma Relat Disord

Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.

Published: October 2024

AI Article Synopsis

  • Systemic sclerosis is an autoimmune disorder that often affects the gastrointestinal tract, leading to anorectal dysfunction and faecal incontinence due to internal anal sphincter atrophy.
  • A study involving 17 patients with systemic sclerosis showed that they had significantly lower internal anal sphincter thickness and resting pressures compared to a matched control group.
  • The findings indicate that internal anal sphincter atrophy contributes to faecal leakage, suggesting a need for further research on risk factors and treatment effectiveness for faecal incontinence in systemic sclerosis patients.

Article Abstract

Systemic sclerosis is an autoimmune disorder which frequently affects the gastrointestinal tract. Anorectal dysfunction is common in systemic sclerosis and is manifested mainly by atrophy of internal anal sphincter. Faecal incontinence is the result of internal anal sphincter atrophy secondary to systemic sclerosis. In this study, we aimed to assess the internal anal sphincter in 17 patients with faecal incontinence and systemic sclerosis using anorectal manometry and endoanal ultrasound and compare them with an age and gender-matched control group without systemic sclerosis. Most patients have limited cutaneous systemic sclerosis. Majority of the patients with systemic sclerosis and faecal incontinence presented with symptoms of faecal leakage and urgency. Systemic sclerosis patients had low basal sphincter pressures. The mean thickness of internal anal sphincter in systemic sclerosis group was significantly lower than the control group (p < 0.001). Rectal sensation is preserved in systemic sclerosis. There was no difference in the mean thickness of the external anal sphincter between the two groups. To conclude internal anal sphincter is atrophic in systemic sclerosis resulting in decreased resting sphincter pressures and passive faecal leakage. Further investigations and studies are needed to determine the natural course of faecal incontinence in systemic sclerosis, associated risk factors and efficacy of therapeutic interventions.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459476PMC
http://dx.doi.org/10.1177/23971983241241203DOI Listing

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