FUNCTIONAL AND ANATOMICAL ANALYSIS OF THE ANORECTUM OF FEMALE SCLERODERMA PATIENTS AT A CENTER FOR PELVIC FLOOR DISORDERS
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos de gastroenterologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032018000500047 |
Resumo: | ABSTRACT BACKGROUND: Scleroderma or progressive systemic sclerosis is characterized by a chronic inflammatory process with proliferation of fibrous connective tissue and excessive deposition of collagen and extracellular matrix in the skin, smooth muscle, and viscera. The smooth muscle most involved in scleroderma is that of the esophagus, and dysphagia is the most commonly reported symptom. However, the internal anal sphincter may also be impaired by degeneration and fibrosis, leading to concomitant anal incontinence in scleroderma patients. These patients may neglect to complain about it, except when actively questioned. OBJECTIVE: To assess anorectal function and anatomy of female scleroderma patients with symptoms of anal incontinence through Cleveland Clinic Florida Fecal Incontinence Score (CCFIS), anorectal manometry and endoanal ultrasound at the outpatient clinic of colorectal and anal physiology, Clinics Hospital, University of São Paulo Medical School (HC-FMUSP). METHODS: Female scleroderma patients were prospectively assessed and questioned as to symptoms of anal incontinence. The anorectal manometry and endoanal ultrasound results were correlated with clinical data and symptoms. RESULTS: In total, 13 women were evaluated. Their mean age was 55.77 years (±16.14; 27-72 years) and their mean disease duration was 10.23 years (±6.23; 2-23 years). All had symptoms of fecal incontinence ranging from 1 to 15. Seven (53.8%) patients had fecal incontinence score no higher than 7; three (23.1%) between 8 and 13; and three (23.1%) 14 or higher, corresponding to mild, moderate, and severe incontinence, respectively. Ten (76.92%) patients had hypotonia of the internal anal sphincter. Three-dimensional endoanal ultrasound showed tapering associated with muscle atrophy of the internal sphincter in six cases and previous muscle defects in three cases. CONCLUSION: A functional and anatomical impairment of the sphincter is an important factor to assess in patients with progressive systemic sclerosis and it should not be underestimated. |
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FUNCTIONAL AND ANATOMICAL ANALYSIS OF THE ANORECTUM OF FEMALE SCLERODERMA PATIENTS AT A CENTER FOR PELVIC FLOOR DISORDERSSystemic sclerodermaFecal incontinenceManometryUltrasonographyABSTRACT BACKGROUND: Scleroderma or progressive systemic sclerosis is characterized by a chronic inflammatory process with proliferation of fibrous connective tissue and excessive deposition of collagen and extracellular matrix in the skin, smooth muscle, and viscera. The smooth muscle most involved in scleroderma is that of the esophagus, and dysphagia is the most commonly reported symptom. However, the internal anal sphincter may also be impaired by degeneration and fibrosis, leading to concomitant anal incontinence in scleroderma patients. These patients may neglect to complain about it, except when actively questioned. OBJECTIVE: To assess anorectal function and anatomy of female scleroderma patients with symptoms of anal incontinence through Cleveland Clinic Florida Fecal Incontinence Score (CCFIS), anorectal manometry and endoanal ultrasound at the outpatient clinic of colorectal and anal physiology, Clinics Hospital, University of São Paulo Medical School (HC-FMUSP). METHODS: Female scleroderma patients were prospectively assessed and questioned as to symptoms of anal incontinence. The anorectal manometry and endoanal ultrasound results were correlated with clinical data and symptoms. RESULTS: In total, 13 women were evaluated. Their mean age was 55.77 years (±16.14; 27-72 years) and their mean disease duration was 10.23 years (±6.23; 2-23 years). All had symptoms of fecal incontinence ranging from 1 to 15. Seven (53.8%) patients had fecal incontinence score no higher than 7; three (23.1%) between 8 and 13; and three (23.1%) 14 or higher, corresponding to mild, moderate, and severe incontinence, respectively. Ten (76.92%) patients had hypotonia of the internal anal sphincter. Three-dimensional endoanal ultrasound showed tapering associated with muscle atrophy of the internal sphincter in six cases and previous muscle defects in three cases. CONCLUSION: A functional and anatomical impairment of the sphincter is an important factor to assess in patients with progressive systemic sclerosis and it should not be underestimated.Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. 2018-11-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032018000500047Arquivos de Gastroenterologia v.55 suppl.1 2018reponame:Arquivos de gastroenterologia (Online)instname:Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologiainstacron:IBEPEGE10.1590/s0004-2803.201800000-49info:eu-repo/semantics/openAccessPINTO,Rodrigo AmbarCORRÊA NETO,Isaac José FelippeNAHAS,Sérgio CarlosBUSTAMANTE LOPES,Leonardo AlfonsoSOBRADO JÚNIOR,Carlos WalterCECCONELLO,Ivaneng2018-11-22T00:00:00Zoai:scielo:S0004-28032018000500047Revistahttp://www.scielo.br/aghttps://old.scielo.br/oai/scielo-oai.php||secretariaarqgastr@hospitaligesp.com.br1678-42190004-2803opendoar:2018-11-22T00:00Arquivos de gastroenterologia (Online) - Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologiafalse |
dc.title.none.fl_str_mv |
FUNCTIONAL AND ANATOMICAL ANALYSIS OF THE ANORECTUM OF FEMALE SCLERODERMA PATIENTS AT A CENTER FOR PELVIC FLOOR DISORDERS |
title |
FUNCTIONAL AND ANATOMICAL ANALYSIS OF THE ANORECTUM OF FEMALE SCLERODERMA PATIENTS AT A CENTER FOR PELVIC FLOOR DISORDERS |
spellingShingle |
FUNCTIONAL AND ANATOMICAL ANALYSIS OF THE ANORECTUM OF FEMALE SCLERODERMA PATIENTS AT A CENTER FOR PELVIC FLOOR DISORDERS PINTO,Rodrigo Ambar Systemic scleroderma Fecal incontinence Manometry Ultrasonography |
title_short |
FUNCTIONAL AND ANATOMICAL ANALYSIS OF THE ANORECTUM OF FEMALE SCLERODERMA PATIENTS AT A CENTER FOR PELVIC FLOOR DISORDERS |
title_full |
FUNCTIONAL AND ANATOMICAL ANALYSIS OF THE ANORECTUM OF FEMALE SCLERODERMA PATIENTS AT A CENTER FOR PELVIC FLOOR DISORDERS |
title_fullStr |
FUNCTIONAL AND ANATOMICAL ANALYSIS OF THE ANORECTUM OF FEMALE SCLERODERMA PATIENTS AT A CENTER FOR PELVIC FLOOR DISORDERS |
title_full_unstemmed |
FUNCTIONAL AND ANATOMICAL ANALYSIS OF THE ANORECTUM OF FEMALE SCLERODERMA PATIENTS AT A CENTER FOR PELVIC FLOOR DISORDERS |
title_sort |
FUNCTIONAL AND ANATOMICAL ANALYSIS OF THE ANORECTUM OF FEMALE SCLERODERMA PATIENTS AT A CENTER FOR PELVIC FLOOR DISORDERS |
author |
PINTO,Rodrigo Ambar |
author_facet |
PINTO,Rodrigo Ambar CORRÊA NETO,Isaac José Felippe NAHAS,Sérgio Carlos BUSTAMANTE LOPES,Leonardo Alfonso SOBRADO JÚNIOR,Carlos Walter CECCONELLO,Ivan |
author_role |
author |
author2 |
CORRÊA NETO,Isaac José Felippe NAHAS,Sérgio Carlos BUSTAMANTE LOPES,Leonardo Alfonso SOBRADO JÚNIOR,Carlos Walter CECCONELLO,Ivan |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
PINTO,Rodrigo Ambar CORRÊA NETO,Isaac José Felippe NAHAS,Sérgio Carlos BUSTAMANTE LOPES,Leonardo Alfonso SOBRADO JÚNIOR,Carlos Walter CECCONELLO,Ivan |
dc.subject.por.fl_str_mv |
Systemic scleroderma Fecal incontinence Manometry Ultrasonography |
topic |
Systemic scleroderma Fecal incontinence Manometry Ultrasonography |
description |
ABSTRACT BACKGROUND: Scleroderma or progressive systemic sclerosis is characterized by a chronic inflammatory process with proliferation of fibrous connective tissue and excessive deposition of collagen and extracellular matrix in the skin, smooth muscle, and viscera. The smooth muscle most involved in scleroderma is that of the esophagus, and dysphagia is the most commonly reported symptom. However, the internal anal sphincter may also be impaired by degeneration and fibrosis, leading to concomitant anal incontinence in scleroderma patients. These patients may neglect to complain about it, except when actively questioned. OBJECTIVE: To assess anorectal function and anatomy of female scleroderma patients with symptoms of anal incontinence through Cleveland Clinic Florida Fecal Incontinence Score (CCFIS), anorectal manometry and endoanal ultrasound at the outpatient clinic of colorectal and anal physiology, Clinics Hospital, University of São Paulo Medical School (HC-FMUSP). METHODS: Female scleroderma patients were prospectively assessed and questioned as to symptoms of anal incontinence. The anorectal manometry and endoanal ultrasound results were correlated with clinical data and symptoms. RESULTS: In total, 13 women were evaluated. Their mean age was 55.77 years (±16.14; 27-72 years) and their mean disease duration was 10.23 years (±6.23; 2-23 years). All had symptoms of fecal incontinence ranging from 1 to 15. Seven (53.8%) patients had fecal incontinence score no higher than 7; three (23.1%) between 8 and 13; and three (23.1%) 14 or higher, corresponding to mild, moderate, and severe incontinence, respectively. Ten (76.92%) patients had hypotonia of the internal anal sphincter. Three-dimensional endoanal ultrasound showed tapering associated with muscle atrophy of the internal sphincter in six cases and previous muscle defects in three cases. CONCLUSION: A functional and anatomical impairment of the sphincter is an important factor to assess in patients with progressive systemic sclerosis and it should not be underestimated. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-11-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032018000500047 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032018000500047 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/s0004-2803.201800000-49 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. |
publisher.none.fl_str_mv |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. |
dc.source.none.fl_str_mv |
Arquivos de Gastroenterologia v.55 suppl.1 2018 reponame:Arquivos de gastroenterologia (Online) instname:Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia instacron:IBEPEGE |
instname_str |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia |
instacron_str |
IBEPEGE |
institution |
IBEPEGE |
reponame_str |
Arquivos de gastroenterologia (Online) |
collection |
Arquivos de gastroenterologia (Online) |
repository.name.fl_str_mv |
Arquivos de gastroenterologia (Online) - Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia |
repository.mail.fl_str_mv |
||secretariaarqgastr@hospitaligesp.com.br |
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1754193349370183680 |