Rectal Sensory-Motor Alterations: A Clinical Perspective on Anorectal Disorders

Abstract Background Altered rectal sensation and motility are prevalent in various anorectal disorders. However, the correlation between rectal sensation and motility has not been well-defined. The aims of this study are to determine the association between these two factors in anorectal disorders and to clarify the underlying mechanisms, thereby offering innovative insights for therapeutic approaches. Methods Retrospectively, we evaluated clinical data from 954 patients with anorectal disorders, who underwent high-resolution anorectal manometry for rectal motility and sensory testing. Regression analysis was performed to evaluate the associations between the rectal sensation and motility across different age and gender strata within different diseases. Results Significant variations in rectal sensations were observed across different diseases, with patients who had undergone rectal cancer surgery exhibiting the lowest sensory threshold volumes (P < 0.01). The constipated patients exhibited significant correlations between rectal sensory thresholds and motility (P < 0.001), with positive associations with maximum squeezing pressure and negative associations with rectoanal gradient and manometric defecation index. For rectal cancer and postoperative patients, only the maximum tolerable volume showed correlation with rectal motility (P < 0.05), including anal resting pressure, rectoanal gradient, and manometric defecation index. Regression analysis revealed that age and gender had a limited impact on the correlation between rectal sensation and motility. Conclusions Patients with anorectal diseases exhibit substantial variations in rectal sensation and motility, with a significant correlation observed between these factors. The correlation is notably influenced by age and gender in patients with constipation and rectal cancer, suggesting that similar relationships may be observed across various anorectal disorders. Registration number ChiCTR2400086148 Reg Date 2024-06-26 00:00:00