Figure 1:
Figure 2:
![High resolution anorectal manometry showing (a) recto-anal areflexia [PAIR not elicited], (b) anal normotension with hypo-contractility.](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6473669b4e662f30ba53cb9e/j_rjim-2025-0012_fig_002.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20251205%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251205T124015Z&X-Amz-Expires=3600&X-Amz-Signature=172d5d9f97c3ecd74d7ab3965371415e7a146685547b35a96ba9143b8e4bd05d&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
Baseline characteristics of the study population (n = 50)
| Age (years) Mean ± SD. | 37.60 ± 12.58 |
| Male gender (n, %) | 20 (40.0) |
| Smoking status (n, %) | |
| Non-smoker | 41 (82.0) |
| Ex-smoker | 5 (10.0) |
| Smoker | 4 (8.0) |
| BMI (kg/m2) | |
| Mean ± SD. | 26.91 ± 4.88 |
| Underweight <18.5 | 1 (2.0) |
| Normal <18.5 – <25 | 17 (34.0) |
| Overweight 25 – <30 | 20 (40.0) |
| Obese ≥30 | 12 (24.0) |
| Symptomatology | |
| Abdominal pain (n, %) | |
| No | 38 (76.0) |
| Mild | 9 (18.0) |
| Moderate | 3 (6.0) |
| Diarrhea | 6 (12.0) |
| Bleeding per rectum (n, %) | |
| No | 43 (86.0) |
| Minimal | 4 (8.0) |
| Mild | 3 (6.0) |
| Clinical examination | |
| Abdominal tenderness (n, %) | |
| No | 41 (82.0) |
| Mild | 9 (18.0) |
| Organomegaly (n, %) | 2 (4.0) |
| Palpable masses (n, %) | 0 (0.0) |
| Peri-anal and DRE (n, %) | |
| Normal | 40 (80.0) |
| Tenderness | 1 (2.0) |
| Skin Tags | 8 (16.0) |
| Tight anal verge | 1 (2.0) |
| Extra-intestinal disease (n, %) | |
| PSC | 1 (2.0) |
| Peripheral arthralgia | 3 (6.0) |
| Episcleritis | 2 (4.0) |
| Bilateral sacroiliitis | 3 (6.0) |
| Laboratory investigations: Mean ± SD. | |
| Hemoglobin (g/dl) | 12.32 ± 1.80 |
| Platelet (×103/μl) | 282.0 ± 104.5 |
| WBCs (×103/μl) | 7.74 ± 2.69 |
| CRP | 5.01 ± 5.01 |
| ESR (mm/h) 1st hour | 14.24 ± 8.88 |
| Fecal calprotectin (μg/g) | 48.85 ± 29.37 |
| Chef defecatory complaint (n, %) | |
| Constipation | 28 (56.0) |
| Fecal incontinence | 10 (20.0) |
| Urgency | 15 (30.0) |
| Incomplete evacuation | 31 (62.0) |
| Proctalgia | 17 (34.0) |
Relation between Anorectal manometry finding and Defecatory disorders (n = 50)
| Defecatory disorders | Anorectal manometry finding | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| RAIR | Anal contractility | Anal tone | Rectoanal co-ordination | Rectal sensation | |||||
| Recto anal areflexia | Hypo contractility | Hypotension | Hypertension | Poor propulsion & dyssynergia | Abnormal expulsion with normal recto-anal coordination | Borderline rectal hyposensitivity | Rectal hyposensitivity | Rectal hypersensitivity | |
| Constipation n=28 | 2 (7.1) | 3 (10.7) | 1 (3.6) | 5 (17.9) | 3 (10.7) | 3 (10.7) | 1 (3.6) | 18 (64.3) | 0 (0.0) |
| Fecal incontinence n= 10 | 1 (10) | 3 (30.0) | 3 (30.0) | 0 (0.0) | 0 (0.0) | 1 (10.0) | 0 (0.0) | 5 (50.0) | 2 (20.0) |
| Urgency n= 15 | 1 (6.7) | 3 (20.0) | 2 (13.3) | 3 (20.0) | 3 (20.0) | 0 (0.0) | 0 (0.0) | 4 (26.7) | 2 (13.3) |
| Incomplete evacuation n= 31 | 1 (3.2) | 5 (16.1) | 1 (3.2) | 3 (9.7) | 3 (9.7) | 3 (9.7) | 3 (9.7) | 14 (45.2) | 0 (0.0) |
| Proctalgian= 17 | 1 (5.9) | 1 (5.9) | 0 (0.0) | 6 (35.3) | 3 (17.6) | 2 (11.8) | 1 (5.9) | 6 (35.3) | 2 (11.8) |
Anorectal manometry finding of the study population (n=50)
| RAIR | N (%) |
| No disorder | 47 (94.0) |
| Recto-anal areflexia | 3 (6.0) |
| Anal contractility | |
| No disorder | 42 (84.0) |
| Hypo contractility | 8 (16.0) |
| Anal tone | |
| No disorder | 40 (80.0) |
| Hypotension | 4 (8.0) |
| Hypertension | 6 (12.0) |
| Recto-anal co-ordination | |
| No disorder | 43 (86.0) |
| Poor propulsion &dyssynergia | 3 (6.0) |
| Abnormal expulsion with normal recto-anal coordination | 4 (8.0) |
| Rectal sensation | |
| No disorder | 23 (46.0) |
| Borderline rectal hyposensitivity | 3 (6.0) |
| Rectal hyposensitivity | 22 (44.0) |
| Rectal hypersensitivity | 2 (4.0) |