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Gut 1999;45(Suppl 2):II55-II59 ( September )

Functional disorders of the anus and rectum

W E Whiteheada, A Waldb, N E Diamantc, P Enckd, J H Pembertone, S S C Raof

a Chair, Committee on Functional Anorectal Disorders, Multinational Working Teams to Develop Diagnostic Criteria for Functional Gastrointestinal Disorders (Rome II), Professor of Medicine, University of North Carolina, Chapel Hill, NC, USA, b Co-Chair, Committee on Functional Anorectal Disorders, Multinational Working Teams to Develop Diagnostic Criteria for Functional Gastrointestinal Disorders (Rome II), University of Pittsburgh Medical Center, Pittsburgh, PA, USA, c The Toronto Hospital, Western Division, Toronto, Ontario, Canada, d Klinik für Gastroenterologie and Infektiolagie, Heinrich Heine Universität, Düsseldorf, Germany, e Mayo Clinic, Rochester, MN, USA, f Department of Internal Medicine, University of Iowa, IA, USA

Correspondence to: William E Whitehead, PhD, Division of Digestive Diseases, CB#7080, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7080, USA. Email: william_whitehead{at}med.unc.edu

In this report the functional anorectal disorders, the etiology of which is currently unknown or related to the abnormal functioning of normally innervated and structurally intact muscles, are discussed. These disorders include functional fecal incontinence, functional anorectal pain, including levator ani syndrome and proctalgia fugax, and pelvic floor dyssynergia. The epidemiology of each disorder is defined and discussed, their pathophysiology is summarized and diagnostic approaches and treatment are suggested. Some suggestions for the direction of future research on these disorders are also given.


Keywords: fecal incontinence; pelvic floor dyssynergia; anismus; proctalgia fugax; levator ani syndrome; constipation; Rome II


© 1999 by Gut



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