Table of Contents
ISRN Gastroenterology
Volume 2013 (2013), Article ID 656921, 8 pages
http://dx.doi.org/10.1155/2013/656921
Clinical Study

Exploring Anorectal Manometry as a Method to Study the Effect of Locally Administered Ropivacaine in Patients with Ulcerative Colitis

1Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, 141 83 Stockholm, Sweden
2Department of Inflammatory Bowel Diseases, HMQ Sophia Hospital, 114 86 Stockholm, Sweden
3Department of Clinical Science, Innovation and Technology, Karolinska Institutet and IBD Clinical Research Group, Karolinska University Hospital, 141 86 Stockholm, Sweden

Received 20 December 2012; Accepted 9 January 2013

Academic Editors: L. Rodrigo and M. Terashima

Copyright © 2013 Eva Arlander et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The symptoms of distal ulcerative colitis have been related to changes in rectal sensitivity and capacity due to inflammation, altered gastrointestinal motility, and sensory perception. With the use of anorectal manometry, the function was measured in seven patients with active distal proctitis during local treatment with ropivacaine. Seven healthy subjects were studied in the same way for comparison with normal conditions. The anal resting pressure and squeezing pressure were similar in all groups. Significantly lower rectal distention volumes were required for rectal sensation, critical volume, and to induce rectal contractility in patients with active disease compared to controls. Rectal compliance was significantly reduced in patients with active and quiescent disease. The increased rectal sensitivity and contractility in patients with active colitis appear to be related to active mucosal inflammation and ulceration. The frequency and urgency of defecation and the fecal incontinence may be due to a hypersensitive, hyperactive, and poorly compliant rectum. The findings in our study indicate that the inflammatory damage to the rectal wall with poor compliance is unaffected by local anaesthetics such as ropivacaine. The symptomatic relief and reduction in clinical symptoms following treatment are not reflected in the anorectal manometric findings.