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Introduction: Anorectal anomalies (ARA) are a range of congenital conditions ranging from a slight malposition of the anus to complex anomalies of the hindgut and urogenital organ. Despite advanced surgical and treatment modalities, voluntary bowel control is poor following surgical care with high rates of faecal incontinence (FI), and also constipation after all grades of reconstructive surgery. The main aim was to determine the impact that FI and constipation has on psychosocial functioning in the context of ARA in comparison to patients with idiopathic constipation (IC) and healthy controls. We also investigated the pathophysiological mechanisms that might contribute to poor bowel function in patients with ARA. Methods: Study comprised 52 patients (19 females; range 11-43 years) with ARA, 46 (13 females; range 11-31 years) IC and 51 healthy controls (26 females; range 11-42 years). Constipation and FI were evaluated using KESS and Vaizey scores respectively (a higher score indicating greater symptom severity). Psychometric tests included: Gastrointestinal Quality of Life Index, Children's Depression Inventory/Beck Depression Inventory, General Health Questionnaire-28, State-Trait Anxiety Inventory/Children, Pennebaker Inventory of Limbic Languidness, Big Five Inventory, Level of Hopefulness, Cognitive Emotion Regulation Questionnaire and Weinberger Attitude Inventory. Physiological investigations were undertaken in 32 adults, presenting with a history of previous surgery for ARA and urge FI. Physiological assessment included: anal manometry; rectal sensation (balloon distension); pudendal nerve function (motor latencies); endo-anal ultrasound; colonic transit and proctography. Results: Significantly higher KESS scores were found in patients with IC |
