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- W2146281986 abstract "<h3>Introduction</h3> Internal anal sphincter (IAS) degeneration is the cause of up to 13% of faecal incontinence referrals to a tertiary centre. The authors speculated that IAS degeneration may represent one aspect of a pan-enteric sphincter dysfunction, and investigated lower oesophageal sphincter (LOS) function and gastro-oesophageal reflux symptoms in these patients. <h3>Methods</h3> In 14 consecutive incontinent patients with IAS degeneration (confirmed by endoanal ultrasound and manometry), the authors measured anal sphincter Resting Pressure (RP), LOS pressure and ambulatory pH-metry. None complained of reflux symptoms. Patients were stratified into two groups based on the total percentage time of pH<4: less than 5% (Group A, n=7; 4 females) and more than 5% (Group B, n=7; 4 females). Secondary outcome measures were the Vaizey incontinence scores and gastro-oesophageal disease quality of life (GORD-HRQL-total, plus heartburn and regurgitation subscores). Comparison of these parameters, correlations and linear regressions between primary and secondary outcome measures were performed. <h3>Results</h3> Group B patients were significantly older than Group A patients (70±7 vs 54±15 years, p=0.005), had lower RP (22.8±4.3 vs 38.5±8.2 mm Hg, p=0.007 respectively) and LOS pressure (5.7±2.1 vs 10.7±4.5 mm Hg, p=0.017 respectively). There was no difference in IAS thickness between the 2 groups (1.2±0.3 mm for both, p=0.902). Vaizey incontinence scores were similar in the 2 groups (A=18.1±3.1 vs B=17.3±2.5), while all 3 GORD-HRQL were lower in group A than group B (GORD-HRQL-total 20.7±5.1 vs 49.5±12.4, p=0.001; GORD-HRQL-hb 10±2.7 vs 25.6±9.7, p=0.001 and GORD-HRQL-reg 10.7±3.7 vs 24±3.7, p=0.001) respectively. Correlations and linear regressions showed a significant inverse relationship between RP and GORD-HRQL-reg score (r=−0.844, p<0.001 and β=−0.0997, p=0.007), and RP and IAS thickness (r=−0.844, p<0.001 and β=−1.465, p=0.006). <h3>Conclusion</h3> IAS degeneration in older patients seems to be associated with significant dysfunction of lower oesophageal sphincter. Further morphological and physiological study should determine if a similar pattern of ageing affects smooth muscle in the gastrointestinal tract." @default.
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- W2146281986 date "2011-03-13" @default.
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- W2146281986 title "Is internal anal sphincter degeneration associated with lower oesophageal sphincter dysfunction?" @default.
- W2146281986 doi "https://doi.org/10.1136/gut.2011.239301.396" @default.
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