AI Article Synopsis

  • The study aimed to assess defecography as a method for evaluating anorectal function in multiple sclerosis patients suffering from severe constipation.
  • Eleven patients with MS participated, undergoing defecography with barium to visualize rectal function during defecation.
  • Results showed common issues like incomplete rectal emptying and insufficient relaxation of relevant muscles, highlighting the utility of defecography in identifying anorectal obstructions in this patient group.

Article Abstract

Purpose: To evaluate defecography in assessment of anorectal function in patients with multiple sclerosis (MS) who have intractable constipation.

Materials And Methods: Eleven patients with MS and constipation (10 women, one man) underwent defecography. A total of 130 mL of barium, liquid (20 mL) and paste, was introduced into the rectum. A dab of barium marked the external anal orifice, and, in the women, a tampon soaked with contrast medium marked the vagina. Video radiographic images and supplemental 100-mm static camera images were obtained.

Results: During defecation, six patients had no puborectalis muscle effacement, four patients had partial effacement, and one patient had complete effacement. No rectal emptying occurred in five patients, and emptying was incomplete in the rest. Three patients developed an intussusception, and two developed a posterolateral pouch.

Conclusion: Defecography readily demonstrates rectal outlet obstruction and the failure of the puborectalis and anal sphincter muscles to relax. These are frequent findings in MS patients with intractable constipation.

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Source
http://dx.doi.org/10.1148/radiology.191.2.8153339DOI Listing

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