Abstract:

Objective To investigate the characteristics of anorectal manometrics of functional constipa⁃ tion（FC）patients with different genders，ages，and symptoms，and furthermore guide the application of this tech⁃ nique to better assist clinical diagnosis and treatment. Methods A retrospective analysis was carried out on 85 pa⁃ tients，enrolled from Gastrointestinal Movement Department of Geriatics Institute of Guangdong Provincial People′s Hospital，with FC and defecation disorders. Among them，32 were younger than 60 years old（non⁃elderly group）， 53 were 60 years old and above（elderly group）. Three ⁃dimensional high ⁃ resolution anorectal manometry（3DH ⁃ ARM）was used to measure anorectal pressure，and unravel characteristics of pressure changes in patients with FC of different gender，age，and different symptoms. Results 3DH⁃ARM showed that the resting pressure and maxi⁃ mum systolic pressure of the anal canal，anal laxation rate and anorectal pressure difference were significantly dif⁃ ferent between the elderly and non⁃elderly groups（P＜0.05）. Maximum systolic pressure of the anal canal，rectal pressure and anal laxation rate were observed significantly different with gender in non ⁃elderly group（P＜0.05）. While in theelderly group，significant gender difference was found in resting pressure and maximum systolic pres⁃ sure of the anal canal，anorectal pressure difference（P＜0.05）. Patients were further divided into Bristol 1 ~ 3 and Bristol 4 ~ 7 groups based on different stool characteristics. The rate of anal laxation of Bristol4⁃7 group was higher than that in Bristol1⁃3 group（P < 0.05），no significant difference was observed in other anorectal manomet⁃ rics（P > 0.05）. Conclusions FC in either age was caused by insufficient rectal propulsion and uncoordinated contraction of pelvic floor muscles. Furthermore，FC in older age was associated with a weaker rectal propulsion. whereas uncoordinated contraction of rectus lead to FC in non ⁃elderly patients. Contractility of the anal canal low anal laxation rate was present among non⁃elderly male with FC，while those non⁃elderly female patients feature elderly male patients，indicating the decreased pressure gradient could be a major cause of FC in the elderly male. 3DH ⁃ARM features good application value in the diagnosis and treatment of FC caused by defecation disorders， and was worth being applied in clinical practice. 

Key words:

three ? dimensional high ? resolution anorectal manometry, functional constipation, age, gender