Dyssynergic Defecation, Impaired Rectal Evacuation, Puborectalis Syndrome
Conditions
Keywords
Dyssynergic defecation, Puborectalis syndrome, Defecography, High-resolution anorectal manometry, Pelvic Floor Ultrasound
Brief summary
Patients with suspected DD who met the Rome IV criteria were divided into the DD group and other types of constipation groups. The differences between the two groups were analyzed to explore the precise diagnostic scheme for DD.
Detailed description
This study was conducted solely at the Army Specialized Medical Center and was a single-center, bidirectional cohort study. Patients with suspected dyssynergic defecation who visited the constipation specialty clinic of Daping Hospital were collected. After the patients signed the informed consent form, they were asked to fill out the questionnaire (general clinical data questionnaire, Wexner constipation rating scale, ODS rating scale, and constipation patient quality of life scale (PAC-QOL)). The baseline data of the patients (such as age, gender, symptoms, constipation scale scores, intestinal satisfaction scores, etc.) and the results of anorectal manometry, defecography, and perineal ultrasound were statistically analyzed. Patients meeting the Rome IV criteria were grouped through DFG, ARM, and pelvic floor ultrasound examination. The differences in clinical main symptoms, constipation scores, defecography, perineal ultrasound, etc. between the two groups were observed, and the roles and correlations of each parameter in diagnosis were analyzed.
Interventions
OTHERAnalysis of inter-group differences
Analysis of inter-group differences
Sponsors
Third Military Medical University
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
16 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
1. Age ranges from 16 to 85 years old. 2. Constipation patients should meet the Rome Ⅳ criteria for chronic constipation (must include two or more of the following: ① At least 25% of bowel movements are strenuous; ② At least 25% of bowel movements are lumpy or hard stools; ③ At least 25% of bowel movements are accompanied by a sense of incomplete evacuation; ④ At least 25% of bowel movements are associated with a feeling of anorectal obstruction or blockage; ⑤ At least 25% of bowel movements require manual assistance; ⑥ Fewer than 3 bowel movements per week). The healthy volunteer group has no above - mentioned constipation symptoms. 3. Participants should be able to understand and complete relevant questionnaires. 4. Participants should be willing to follow the research protocol and sign the informed consent form.
Exclusion criteria
1. Pregnant women and lactating women 2. Suffering from gastrointestinal and other malignant tumors 3. Suffering from diseases such as diabetes and Parkinson's disease 4. Currently participating in other clinical trials
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rectal emptying rate，（%） | Baseline assessment | Rectal emptying rate is defined as the reduction in rectal area from pre-evacuation to post-evacuation, expressed as a percentage of the pre-evacuation area, as assessed by defecography. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Obstructed Defecation Syndrome score，（ODS score） | Baseline assessment | the minimum value is 0,and maximum value is 31; a higher scores mean a worse outcome. |
| Cleveland Clinic Constipation Score,(CCCS) | Baseline assessment | the minimum value is 0,and maximum value is 30; a higher scores mean a worse outcome. |
| Patient Assessment of Constipation Quality of Life total score，（PAC-QOL score） | Baseline assessment | the minimum value is 0,and maximum value is 112; a higher scores mean a worse outcome. |
| Self-Rating Anxiety Scale score，（SAS score） | Baseline assessment | the minimum value is 25,and maximum value is 100; a higher scores mean a worse outcome. |
| Bristol Stool Form Scale score | Baseline assessment | the minimum value is 1,and maximum value is 7; a higher scores mean a worse outcome. |
| Body Mass Index | Baseline assessment | — |
| Disease duration,(year) | Baseline assessment | — |
| ARA change on DFG，(°) | Baseline assessment | changes in anorectal angle during defecography |
| Anal canal diameter on DFG，（mm） | Baseline assessment | anal canal diameter during straining on DFG |
| PRS on DFG | Baseline assessment | Puborectalis syndrome indicated by the defecography diagnostic report. |
| IRP on DFG | Baseline assessment | Internal rectal prolapse indicated by the defecography diagnostic report. |
| Rectocele on DFG | Baseline assessment | Rectocele indicated by the defecography diagnostic report. |
| Anal Resting Pressure，（mmHg） | Baseline assessment | Anal Resting Pressure measured by High-resolution Anorectal Manometry |
| Anal Squeeze Pressure,(mmHg) | Baseline assessment | Anal Squeeze Pressure measured by High-resolution Anorectal Manometry |
| Rectal propulsive pressure,(mmHg) | Baseline assessment | Rectal propulsive pressure measured by High-resolution Anorectal Manometry |
| Anal relaxation rate,(%) | Baseline assessment | Anal relaxation rate measured by High-resolution Anorectal Manometry during defecation |
| DD on HR-ARM | Baseline assessment | Dyssynergic defecation(DD) reported by high-resolution anorectal manometry parameters, with diagnostic criteria of rectal pressure during straining \>45mmHg and anal canal relaxation rate \<20%. |
| ARA change on TPUS,(°) | Baseline assessment | changes in anorectal angle during evacuation measured by Transperineal Ultrasound |
| Right PRM thickness change on TPUS,(mm) | Baseline assessment | Changes in right puborectalis muscle thickness during defecation measured by Transperineal Ultrasound |
| Left PRM thickness change on TPUS,(mm) | Baseline assessment | Changes in left puborectalis muscle thickness during defecation measured by Transperineal Ultrasound |
| PRS on TPUS | Baseline assessment | Puborectalis syndrome(PRS) indicated by the transperineal ultrasound diagnostic report |
Countries
China
Contacts
STUDY_DIRECTORWeidong Tong, MD
Army Medical Center (Daping Hospital)
Outcome results
None listed