Internal anal sphincter achalasia: Outcome after internal sphincter myectomy

Caluwé, D. De; Yoneda, Akihiro; Akl, Usama; Puri, Prem

doi:10.1053/jpsu.2001.22949

Cited by 68 publications

(25 citation statements)

References 5 publications

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“…The IAS relaxes in response to rectal distension, a phenomenon called the rectosphincteric inhibitory reflex, which is mediated by intramural nerves descending from the rectum to the IAS [146]. Internal anal sphincter achalasia (IASA) is a clinical condition with presentation similar to HD but with the presence of ganglion cells on rectal biopsy [147][148][149][150][151][152][153]. The diagnosis of IASA is made on anorectal manometry, which shows the absence of rectosphincteric reflex on the balloon inflation.…”

Section: Internal Sphincter Achalasiamentioning

confidence: 99%

Interstitial cells of Cajal in the normal gut and in intestinal motility disorders of childhood

2007

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Interstitial cells of Cajal (ICCs) are pacemaker cells which are densely distributed throughout the whole gastrointestinal tract. ICCs have important functions in neurotransmission, generation of slow waves and regulation of mechanical activities in the gastrointestinal tract, especially for the coordinated gastrointestinal peristalsis. Therefore, a loss of ICCs could result in gastrointestinal motor dysfunction. In recent years c-kit labeling has been widely used to study pathological changes of ICCs in gastrointestinal motility disorders. Paediatric gastrointestinal motility disorders such as hypertrophic pyloric stenosis, Hirschsprung's disease, total colonic aganglionosis, hypoganglionosis, intestinal neuronal dysplasia, internal anal sphincter achalasia, megacystis microcolon intestinal hypoperistalsis syndrome have been reported to be associated with loss or deficiency of ICCs networks. This review describes the distribution of ICCs in the normal gastrointestinal tract and its altered distribution in intestinal motility disorders of childhood.

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Section: Internal Sphincter Achalasiamentioning

confidence: 99%

Interstitial cells of Cajal in the normal gut and in intestinal motility disorders of childhood

2007

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“…In Holschneider's [10] review of the literature, 144 of 189 patients had excellent results after myectomy; in 38 patients, the situation had improved; and the result was unsatisfactory in 11 children. De Caluwe et al [2] reported 2-6 years follow-up of 15 patients after ISM. Seven of these 15 patients had regular bowel movement without any laxatives, six needed small doses of laxatives, and one patient was able to stay clean with a regular enemas.…”

Section: Discussionmentioning

confidence: 99%

“…DeCaluwe et al [2] also had one patient who required resection of dilated bowel afterwards. If the rectosigmoid is extremely dilated because of IASA, it may not have enough peristaltic capacity to ensure effective bowel emptying despite the fact that the outlet obstruction caused by internal sphincter hypertonicity is alleviated by the myectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Previously, IASA has been referred to as ultra-short segment Hirschsprung's disease. The term IASA reflects more accurately the failure of relaxation of the internal sphincter, which causes the symptoms of IASA [2]. Complex neuronal abnormalities have been found to occur in IASA.…”

Section: Introductionmentioning

confidence: 99%

“…The average incidence of ultra-short Hirschsprung's disease is estimated to be 11-14% in relation to all aganglionoses [4]. DeCaluwe et al [2] found that 4.5% of their patients who were investigated for chronic constipation had IASA.…”

Section: Introductionmentioning

confidence: 99%

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Long-term outcome after internal sphincter myectomy for internal sphincter achalasia

2004

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Anal internal sphincter achalasia is a rare cause of refractory constipation. It is usually treated by internal sphincter myectomy (ISM). The aim of this study was to evaluate the long-term outcome of patients who had undergone ISM for internal sphincter achalasia. Bowel habits, fecal continence, and quality of life were evaluated using a questionnaire. Fecal continence was quantitatively assessed by a score described by Holschneider. A questionnaire was sent to 13 patients (11 male, two female) operated on by ISM for intractable constipation caused by internal sphincter achalasia between 1983 and 1993. Ten patients responded and were included in the study. At the time of the study, three of the 10 patients required oral medication for constipation and had one to three bowel movements per week. One of the 10 patients had three to five bowel movements per day, and the others had one to two bowel movements per day. Four patients had normal and six patients had good continence scores. Four of the patients reported mild social problems, and one had problems associated with sports. Refractory constipation in the majority of patients with internal sphincter achalasia can be treated by ISM. However, in the long term, a significant number of patients suffer from soiling-related social problems.

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Botulinum toxin for the treatment of chronic idiopathic constipation

et al. 2009

Cochrane Database of Systematic Reviews

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Internal anal sphincter achalasia: Outcome after internal sphincter myectomy

Cited by 68 publications

References 5 publications

Interstitial cells of Cajal in the normal gut and in intestinal motility disorders of childhood

Interstitial cells of Cajal in the normal gut and in intestinal motility disorders of childhood

Long-term outcome after internal sphincter myectomy for internal sphincter achalasia

Botulinum toxin for the treatment of chronic idiopathic constipation

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