P063 Manometric Study and the Role of the Perianal Disease and the Clinical Activity in Anorectal Dysfunction in Crohn's Disease
Notice bibliographique
Résumé
BACKGROUND: Although Crohn's disease frequently affects the perianal region and its function, studies evaluating anorectal function in these patients are rare and with controversial results. The impact of perianal disease on anorectal function complaints is not clear, other factors such as disease activity, stool consistency and decreased rectal capacity may have a more important role in its pathogenesis. Athanasios et al. found no association between the values of resting and squeeze pressure and fecal incontinence in Crohn's disease (CD) patients. According to the authors, this result could be explained by the difference in the pathophysiology of fecal incontinence among patients with inflammatory bowel disease (IBD). The aim of this study is to determine associated manometric factors, the role of perianal disease, disease activity and fecal consistency in anorectal dysfunction in CD patients. METHODS: This is an observational, cross-sectional study. Fifty-six Crohn's disease patient under outpatient follow-up, completed a questionnaire and were submitted to a medical record review, and anorectal manometry. Manometric variables studied: resting and squeeze pressure, anismus, rectoanal inhibitory reflex (RAIR), rectal sensitivity and capacity and proof of balloon expulsion. Functional disorders studied: fecal incontinence and urgency, incomplete/obstructed evacuation and tenesmus. Software R for Windows, version 4.0.2 was used for the statistical analyses. Pearson's χ2 test, Fisher's exact test and T-Student Test for independence was used to study the association between manometric and clinical variables and functional disorders, with P < 0,05. RESULTS: Of the 56 patients evaluated, 53.6% are male, with a mean age of 41.4 years (SD: 12.4). According to the Montreal Classification, most patients have non-penetrating/non-stenosing disease (61.5%). Perianal disease, was present in 44.2% of the patients. Most patients were in remission, according to the Harvey-Bradshaw Index. Among the functional complaints, the most common is fecal incontinence (38%), followed by a sensation of obstructed/incomplete evacuation (36%) and fecal urgency (29%). When patients with anorectal functional complaints (fecal incontinence, incomplete/obstructed evacuation, fecal urgency and tenesmus) were compared with patients without anorectal functional complaints, no statistically significant difference was found in relation to perianal disease. On the other hand, a statistically significant difference was found when we compared the patients with any anorectal functional complaint (fecal incontinence, incomplete/obstructed evacuation, fecal urgency and tenesmus) with the patient without any complaints in relation to activity index of the disease and fecal consistency. CONCLUSION: Our results suggest that functional complaints in patients with Crohn's disease are more related to disease activity and fecal consistency, among other factors, than structural and functional ano-rectal-perineal abnormality, including those caused by perianal involvement of the disease. Therefore, the control of the disease activity probably is critical for the management of this function symptoms.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».