Evaluation of Rectal Compliance amongst Individuals with Hemorrhoids with or without Fissure and its Comparison with Healthy Individuals

Abstract

Background: A physiological basis of the ailments like hemorrhoids and fissure is necessary for symptom specific treatment of patients. We aimed to evaluate rectal compliance and resting anal pressure by anal manometry as an objective parameter to the disease in these patients and compare them with controls. Material and Methods: Study conducted in 150 patients, after informed consent and IRB approval,in institutional setup, divided into 3 groups. Group 1- patients with Hemorrhoids and fissure in ano (H+F), group 2-Hemorrhoids without fissure (H-F) and group 3-controls without any anorectal pathology. All patients underwent anorectal manometry, results evaluated, noted, and compared between all the three groups. Rectal compliance and resting anal pressure calculated and compared, and its significance evaluated using statistical analysis. Result: Each group consisting of 50 patients underwent Anorectal manometry and rectal compliance compared between all the three groups. Group 1 (H+F) was found to have mean rectal compliance of -0.100 ± 6.70 mL/mmHg, Group 2 (H-F) had a mean value of 8.92 ± 5.29 mL/mmHg and Group 3 (controls) had 13.08 ± 7.61 mL/mmHg of compliance. Group 1 had resting anal pressure of 115.04 ± 26.94mmHg, Group 2 had 79.92 ± 16.88 mmHg and Group 3 had 75.40 ± 28.39mmHg. The difference in rectal compliance and resting anal pressure was statistically significant between Group 1 & 2 and group 1 & 3. Group 2 had a lower rectal compliance and higher resting anal pressure than group 3 but not statistically significant. Conclusion: Hemorrhoids cause significant decrease in rectal compliance and increase in resting anal pressure, more pronounced in fissure in ano as compared to healthy individuals. Therefore, these values can be used as the objective parameter which should be routinely measured in these patients and treatment aimed at correction of the same.