The Showa University Journal of Medical Sciences
Online ISSN : 2185-0968
Print ISSN : 0915-6380
ISSN-L : 0915-6380
Pathophysiology in Diabetic Patients with Fecal Incontinence
Makoto WATANABEAkira TSUNODAGoichi KAMIYAMATsutomu HIRANOMitsuo KUSANO
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JOURNAL FREE ACCESS

2003 Volume 15 Issue 1 Pages 21-26

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Abstract
The aim of this study was to investigate the pathophysiology of fecal incontinence in patients with diabetes mellitus. Methods. Two groups of diabetic patients were studied. Group A consisted of 7 subjects (48 to 76 years, mean age 53.5 years) with fecal incontinence and Group B consisted of 9 subjects (38 to 79 years, mean age 62.1 years) without fecal incontinence. A third group of 10 healthy volunteers (Group C) were included as control subjects. All subjects underwent anorectal manometry and rectal sensitivity tests, and pudendal nerve terminal motor latency ( PNTML) . Results. Anal resting pressure was significantly lower in Group A (38 cm H2O) compared to Group B (60 cm H2O) and Group C (59 cm H2O) . Maximum squeeze pressure was significantly lower in Group A (98 cm H2O) and Group B (160 cm H2O) compared to Group C (240 cm H2O) . Initial sensation volume was significantly higher in Group A (80 cm H2O) compared to Group C (30 cm H2O) . Pudendal nerve terminal motor latency was significantly higher in Group A (3.15 msec) compared to Group B (2.45 msec) and Group C (2.03 msec) . There was no significant difference in the length of the high-pressure zone, urgency, or maximum tolerable volume between the three groups. Conclusion. Our results demonstrate that autonomic neuropathy causes internal sphincter or initial rectal sensation damage, and that somatic neuropathy, such as pudendal neuropathy, may play an important role in fecal incontinence in diabetic patients.
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