RESUMEN
In 12 patients suffering from chronic idiopathic anal pain, the rectosphincteric function was studied using manometric and x-ray techniques. The results of manometric investigations were compared with those obtained in 12 healthy volunteers. In all patients, the resting pressure in the anal canal was significantly higher than in control subjects. In 10 patients, defecography revealed abnormalities of the pelvic muscles. We treated the patients by using biofeedback techniques, consisting of voluntary modifications of the state of contraction of the external sphincter. In all cases, pain disappeared after a mean of eight biofeedback training sessions. When noxious manifestations had disappeared, manometry showed a significant decrease in the anal canal resting pressure. Our results indicate 1) that chronic idiopathic anal pain is associated with abnormal anorectal manometric profiles, probably resulting from a dysfunctioning of the striated external anal sphincter, and 2) that biofeedback training is an effective treatment for chronic idiopathic anal pain.
Asunto(s)
Canal Anal , Biorretroalimentación Psicológica , Manejo del Dolor , Dolor/etiología , Adulto , Anciano , Canal Anal/diagnóstico por imagen , Canal Anal/fisiopatología , Enfermedad Crónica , Defecación , Femenino , Humanos , Masculino , Manometría , Persona de Mediana Edad , Contracción Muscular/fisiología , Presión , Estudios Prospectivos , Radiografía , Reflejo Anormal/fisiologíaRESUMEN
The role of radiological examination in detecting the early colonic cancer is considered. A cost-benefit evaluation between conventional barium enema and double contrast enema justifies the use of D.C.E. for the early detection of colonic cancer.