P0518 Study of the prevalence of defecatory disorders in patients with quiescent ulcerative colitis using high resolution anorectal manometry

Abstract Background Ulcerative colitis is characterized by recurring episodes of inflammation limited to the mucosal layer of the colon. Initially, it affects the rectum, and it may progress in a proximal and continuous manner to encompass other sections of the colon. Anorectal manometry quantifies and evaluates various aspects of the intricate and multifactorial mechanisms that regulate defecation and continence. Methods This study was carried out on 50 ulcerative colitis patients aged from 19 to 76 years old, both sexes, patients who have documented disease remission or mild activity clinically and by colonoscopy for the last six months and had persistent defecatory disorder symptoms. All patients were subjected to detailed history taking, systemic physical examination, laboratory investigations, colonoscopy showing remission or mild activity for the last six months based on Mayo score, and high-resolution anorectal manometry. Results There were statistically significant differences regarding relation between fecal incontinence and duration of the disease (P=0.008), while no significant differences were observed with the ulcerative colitis extension, and the treatment used. Regarding constipation, urgency, incomplete evacuation and proctalgia; there was no statistically significant differences with the duration of the disease, the ulcerative colitis extension, and the treatment used. Conclusion Many ulcerative colitis patients still experience defecatory disorders even at the quiescent stage, and this could be explained by the long-term neuromuscular effect of prolonged inflammation. High resolution anorectal manometry is the most important test to assess anal tone and contractility, recto-anal coordination and rectal sensation. Fecal incontinence in quiescent ulcerative colitis patients is significantly associated with the duration of the disease. References Gajendran M, Loganathan P, Jimenez G, Catinella AP, Ng N, Umapathy C, et al. A comprehensive review and update on ulcerative colitis. Dis Mon. 2019; 65:100-51. Kang HR, Lee JE, Lee JS, Lee TH, Hong SJ, Kim JO, et al. Comparison of high-resolution anorectal manometry with water-perfused anorectal manometry. J Neurogastroenterol Motil. 2015; 21:126-32. Torresan F, Mandolesi D, Bonventre S, Usai P. Differences between conventional anorectal manometry and high resolution\high-definition anorectal manometry. In: Bellini M, editor. High resolution and high-definition anorectal manometry. 5. Cham: Springer; 2020. p.49-68.