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© 1990 Oxford University Press

research-article

Rectal Motility Studies in Faecally Incontinent Geriatric Patients

J. A. BARRETT*, J. C. BROCKLEHURST, E. S. KIFF, G. FERGUSON and E. B. FARAGHER

Department of Geriatric Medicine, University Hospital of South Manchester Manchester M20 8LR
Department of Surgery, University Hospital of South Manchester Manchester M20 8LR
Department of Medical Statistics, University Hospital of South Manchester Manchester M20 8LR

* Address correspondence to Dr J. A. Barrett, Department of Medicine in the Elderly, Clatterbridge Hospital, Wirral, Merseyside L69 4JY

Rectal motility was assessed in three groups of geriatric patients (faecally incontinent, continent faecally impacted and control patients) to determine whether ‘uninhibited’ rectal contractions are a cause of faecal incontinence.

The incidence of rectal contractions in response to rectal distension did not differ between the three study groups. Two-thirds of the incontinent patients were unable to retain a condom distended with water (soft-stool model) during a proctometrogram. Involuntary expulsion of this device was correlated with the presence of rectal contractions and low anal resting pressure. Involuntary expulsion of an air-filled balloon (firm-stool model) from the rectum occurred less frequently and was correlated with low resting pressure but not with rectal contractions.

The contribution of ‘uninhibited’ rectal contractions to faecal incontinence is insignificant except for a minor role in the expulsion of liquid stool.

Received November 23, 1989;
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