Anal sphincter structure and function relationships in aging and fecal incontinence

Christina Lewicky-Gaupp; Quinn Hamilton; James Ashton-Miller; Markus Huebner; John O L DeLancey; Dee E. Fenner

doi:10.1016/j.ajog.2008.11.009

Anal sphincter structure and function relationships in aging and fecal incontinence

Christina Lewicky-Gaupp^*, Quinn Hamilton, James Ashton-Miller, Markus Huebner, John O L DeLancey, Dee E. Fenner

^*Corresponding author for this work

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

38 Scopus citations

Abstract

Objective: The objective of the study was to determine the effect of aging and continence status on the structure and function of the external (EAS) and internal (IAS) anal sphincters. Study Design: Young (YC) and older (OC) continent women were compared with older women with fecal incontinence (OI). Patients completed the Fecal Incontinence Quality of Life and Fecal Incontinence Severity Index and underwent anorectal manometry and transanal ultrasound. Results: Nine YC, 9 OC, and 8 OI women participated. Aging was associated with a thickening of the IAS. Older incontinent women had a thinner EAS, had decreased maximum squeeze pressures, and were hypersensitive to rectal distention with decreased tolerable rectal volumes and urge to defecate at lower volumes. Conclusion: Thickening of the IAS occurs with aging. Thinning of the EAS and a corresponding drop in squeeze pressure correlated with fecal incontinence but not aging. Rectal hypersensitivity was associated with fecal incontinence rather than aging and may play a role in the mechanism of fecal incontinence.

Original language	English (US)
Pages (from-to)	559.e1-559.e5
Journal	American journal of obstetrics and gynecology
Volume	200
Issue number	5
DOIs	https://doi.org/10.1016/j.ajog.2008.11.009
State	Published - May 2009

Keywords

aging
external anal sphincter
fecal incontinence
internal anal sphincter

ASJC Scopus subject areas

Obstetrics and Gynecology

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10.1016/j.ajog.2008.11.009

Cite this

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title = "Anal sphincter structure and function relationships in aging and fecal incontinence",

abstract = "Objective: The objective of the study was to determine the effect of aging and continence status on the structure and function of the external (EAS) and internal (IAS) anal sphincters. Study Design: Young (YC) and older (OC) continent women were compared with older women with fecal incontinence (OI). Patients completed the Fecal Incontinence Quality of Life and Fecal Incontinence Severity Index and underwent anorectal manometry and transanal ultrasound. Results: Nine YC, 9 OC, and 8 OI women participated. Aging was associated with a thickening of the IAS. Older incontinent women had a thinner EAS, had decreased maximum squeeze pressures, and were hypersensitive to rectal distention with decreased tolerable rectal volumes and urge to defecate at lower volumes. Conclusion: Thickening of the IAS occurs with aging. Thinning of the EAS and a corresponding drop in squeeze pressure correlated with fecal incontinence but not aging. Rectal hypersensitivity was associated with fecal incontinence rather than aging and may play a role in the mechanism of fecal incontinence.",

keywords = "aging, external anal sphincter, fecal incontinence, internal anal sphincter",

author = "Christina Lewicky-Gaupp and Quinn Hamilton and James Ashton-Miller and Markus Huebner and DeLancey, {John O L} and Fenner, {Dee E.}",

note = "Funding Information: This study was supported in part by the Claude A. Pepper Foundation Grant P30AG024824 for this project and investigator support by the Office for Research on Women's Health SCOR on Sex and Gender Factors Affecting Women's Health and National Institute of Child Health and Human Development Grant 1 P50 HD044406. ",

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AU - Lewicky-Gaupp, Christina

AU - Hamilton, Quinn

AU - Ashton-Miller, James

AU - Huebner, Markus

AU - DeLancey, John O L

AU - Fenner, Dee E.

N1 - Funding Information: This study was supported in part by the Claude A. Pepper Foundation Grant P30AG024824 for this project and investigator support by the Office for Research on Women's Health SCOR on Sex and Gender Factors Affecting Women's Health and National Institute of Child Health and Human Development Grant 1 P50 HD044406.

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N2 - Objective: The objective of the study was to determine the effect of aging and continence status on the structure and function of the external (EAS) and internal (IAS) anal sphincters. Study Design: Young (YC) and older (OC) continent women were compared with older women with fecal incontinence (OI). Patients completed the Fecal Incontinence Quality of Life and Fecal Incontinence Severity Index and underwent anorectal manometry and transanal ultrasound. Results: Nine YC, 9 OC, and 8 OI women participated. Aging was associated with a thickening of the IAS. Older incontinent women had a thinner EAS, had decreased maximum squeeze pressures, and were hypersensitive to rectal distention with decreased tolerable rectal volumes and urge to defecate at lower volumes. Conclusion: Thickening of the IAS occurs with aging. Thinning of the EAS and a corresponding drop in squeeze pressure correlated with fecal incontinence but not aging. Rectal hypersensitivity was associated with fecal incontinence rather than aging and may play a role in the mechanism of fecal incontinence.

AB - Objective: The objective of the study was to determine the effect of aging and continence status on the structure and function of the external (EAS) and internal (IAS) anal sphincters. Study Design: Young (YC) and older (OC) continent women were compared with older women with fecal incontinence (OI). Patients completed the Fecal Incontinence Quality of Life and Fecal Incontinence Severity Index and underwent anorectal manometry and transanal ultrasound. Results: Nine YC, 9 OC, and 8 OI women participated. Aging was associated with a thickening of the IAS. Older incontinent women had a thinner EAS, had decreased maximum squeeze pressures, and were hypersensitive to rectal distention with decreased tolerable rectal volumes and urge to defecate at lower volumes. Conclusion: Thickening of the IAS occurs with aging. Thinning of the EAS and a corresponding drop in squeeze pressure correlated with fecal incontinence but not aging. Rectal hypersensitivity was associated with fecal incontinence rather than aging and may play a role in the mechanism of fecal incontinence.

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Anal sphincter structure and function relationships in aging and fecal incontinence

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