Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023, 167(4):357-361 | DOI: 10.5507/bp.2022.023

Assessment of defecation disorders using high-resolution MRI-defecography

Ioana Duca1, Ramona Boja2, Dan Lucian Dumitrascu1
1 2nd Medical Clinic, Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, Romania
2 "Phoenix Clinic" Cluj-Napoca, Romania

Aims: The aim of this retrospective study was to try to find correlations between different diagnoses established by clinical examination, anorectal manometry and MRI-defecography and, the association with psychiatric disorders.

Methods: 44 patients (median age 53.81 years) presenting with intestinal motility disorders and who underwent clinical, biological and psychiatric examination, dynamic defecographic-MRI (resting, squeezing, straining, defecation and evacuation phases), anorectal manometry, colonoscopy. MRI was performed using the 1,5 T.

Results: MRI-defecography revealed the following changes: anismus (16), rectocele (12), pelvic floor dysfunction (6), peritoneocele (2), cervical-cystic-ptosis (1), rectal prolapse (6), and in 1 case the examination was normal. Hypertonic anal sphincter (16) and lack of defecation reflex (12) at anorectal manometry correlated with anismus in all patients at MRI-defecography. Lack of inhibitor anal reflex (6) was associated with rectocele (4), cervix-cysto-ptosis (1) and peritoneocele (2). Anxiety (11), depression (6) and anxiety-depressive disorders (10) were found in 27/44, somatization disorders in 9/44 and no psychiatric changes in 8/44 cases.

Conclusion: As multiparous women are at risk for outlet obstruction constipation, MRI-defecography is suggested in this category. There is good correlation between diagnosis using anorectal manometry and MRI-defecography in patients with terminal constipation and anismus. Lower defecation dysfunction is often associated with psychiatric disorders.

Keywords: MRI-defecography, outlet obstruction constipation, defecation dysfunction, anismus

Received: March 5, 2022; Revised: April 29, 2022; Accepted: May 3, 2022; Prepublished online: May 13, 2022; Published: December 4, 2023  Show citation

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Duca, I., Boja, R., & Dumitrascu, D.L. (2023). Assessment of defecation disorders using high-resolution MRI-defecography. Biomedical papers, 167(4), 357-361. doi: 10.5507/bp.2022.023
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