medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-430medsovet-8585Research ArticleЗАБОЛЕВАНИЯ КИШЕЧНИКАBOWEL DISEASESЧастота выявления диссинергической дефекации у пациентов с синдромом перекреста функциональных нарушений органов пищеварения, ассоциированных с запорамиFrequency of detection of dyssynergic defecation in patients with overlap syndrome of functional disorders of the digestive organs associated with constipationhttps://orcid.org/0000-0001-6114-564XМаевИ. В.MaevI. V.

Маев Игорь Вениаминович, академик РАН, д.м.н., профессор, заслуженный деятель науки РФ, заслуженный врач РФ, заведующий кафедрой пропедевтики внутренних болезней и гастроэнтерологии

127473, Москва, ул. Делегатская, д. 20, стр. 1

Igor V. Maev, Acad. RAS, Dr. Sci. (Med.), Professor, Honored Scientist of the Russian Federation, Honored Doctor of the Russian Federation, Head of the Department of Propaedeutics of Internal Diseases and Gastroenterology

20, Bldg. 1, Delegatskaya St., Moscow, 127473

igormaev@rambler.ruhttps://orcid.org/0000-0001-8136-222XГилюкА. В.GilyukA. V.

Гилюк Анастасия Владимировна, аспирант кафедры пропедевтики внутренних болезней и гастроэнтерологии

127473, Москва, ул. Делегатская, д. 20, стр. 1

Anastasia V. Gilyuk, Postgraduate Student of the Department of Propaedeutics of Internal Diseases and Gastroenterology

20, Bldg. 1, Delegatskaya St., Moscow, 127473

dr.gilyuk@mail.ruhttps://orcid.org/0000-0002-4007-7112АндреевД. Н.AndreevD. N.

Андреев Дмитрий Николаевич, к.м.н., доцент, доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии, научный сотрудник лаборатории функциональных методов исследования в гастроэнтерологии

127473, Москва, ул. Делегатская, д. 20, стр. 1

Dmitry N. Andreev, Cand. Sci. (Med.), Associate Professor of the Department of Propaedeutics of Internal Diseases and Gastroenterology, Researcher of the Laboratory of Functional Research Methods in Gastroenterology

20, Bldg. 1, Delegatskaya St., Moscow, 127473

dna-mit8@mail.ruhttps://orcid.org/0000-0002-0327-4280КазюлинА. Н.KazyulinA. N.

Казюлин Александр Нисонович, д.м.н., профессор кафедры пропедевтики внутренних болезней и гастроэнтерологии

127473, Москва, ул. Делегатская, д. 20, стр. 1

Alexander N. Kazyulin, Dr. Sci. (Med.), Professor of the Department of Propaedeutics of Internal Diseases and Gastroenterology

20, Bldg. 1, Delegatskaya St., Moscow, 127473

alexander.kazyulin@yandex.ruРоссийский университет медицины (РосУниМед)РоссияRussian University of Medicine (ROSUNIMED)Russian Federation202417102024015174–181Copyright © Маев И.В., Гилюк А.В., Андреев Д.Н., Казюлин А.Н., 20242024Маев И.В., Гилюк А.В., Андреев Д.Н., Казюлин А.Н.Maev I.V., Gilyuk A.V., Andreev D.N., Kazyulin A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8585Введение

Введение. Наличие диссинергической дефекации в когорте пациентов с синдромом перекреста функциональных нарушений малоизучено.

Цель

Цель. Оценить моторную функцию и параметры чувствительности аноректальной зоны, выявить диссинергическую дефекацию и проанализировать частоту корреляции у пациентов с синдромом перекреста функциональных нарушений органов пищеварения, ассоциированных с запорами.

Материалы и методы

Материалы и методы. Проведено одномоментное обследование в четырех параллельных группах. В исследование включены 100 пациентов в возрасте от 30 до 40 лет с диагнозами: синдром раздраженной толстой кишки с преобладанием запора (СРК-З) (группа 1), СРК-З в сочетании с функциональной диспепсией (группа 2), СРК-З в сочетании с функциональным билиарным расстройством (группа 3) и здоровые добровольцы (группа 0). Всем пациентам проводили тест на изгнание баллона и аноректальную манометрию высокого разрешения для определения наличия диссинергической дефекации.

Результаты

Результаты. На основании анализа параметров по данным аноректальной манометрии в группе 0 не выявлено диссинергической дефекации, в группе 1 диссинергическая дефекация выявлена у 8 человек – 32,0% (95% ДИ 12,3–51,6) , в группе 2 – у 14 человек – 56,0% (95% ДИ 35,0–76,9), в группе 3 – у 16 человек – 64,0% (95% ДИ 43,7–84,2). Отрицательная эвакуаторная проба у пациентов в группе 1 выявлена у 8 (32%) человек, у пациентов в группе 2 – у 14 (56%) человек, у пациентов в группе 3 – у 17 (68%) человек, что явилось подтверждением наличия диссинергической дефекации.

Выводы

Выводы. Настоящее исследование продемонстрировало наличие диссинергической дефекации в трех группах обследуемых, чаще при сочетании синдрома раздраженной толстой кишки с преобладанием запора с функциональной диспепсией, а наиболее часто – с функциональным расстройством желчного пузыря.

Introduction

Introduction. The presence of dyssynergic defecation in a cohort of patients with overlap syndrome of functional disorders is poorly studied.

Aim

Aim. To assess the motor function and sensitivity parameters of the anorectal zone, to identify dyssynergic defecation and to analyze the frequency of correlation in patients with overlap syndrome of functional gastrointestinal disorders associated with constipation.

Materials and methods

Materials and methods. A one-stage examination was conducted in four parallel groups. The study included 100 patients aged 30 to 40 years with the following diagnoses: constipation-p redominance irritable bowel syndrome (IBS-C) (group 1), IBS-C combined with functional dyspepsia (group 2), IBS-C combined with functional biliary disorder (group 3) and healthy volunteers (group 0). All patients underwent a balloon expulsion test and high-resolution anorectal manometry to determine the presence of dyssynergic defecation.

Results

Results. Based on the analysis of parameters according to anorectal manometry data, dyssynergic defecation was not detected in group 0, in group 1 dyssynergic defecation was detected in 8 people – 32.0% (95% CI 12.3–51.6), in group 2 – in 14 people – 56.0% (95% CI 35.0–76.9), in group 3 – in 16 people – 64.0% (95% CI 43.7–84.2). A negative evacuation test was detected in 8 (32%) patients in group 1, in 14 (56%) patients in group 2, and in 17 (68%) patients in group 3, which confirmed the presence of dyssynergic defecation.

Conclusions

Conclusions. This study demonstrated the presence of dyssynergic defecation in three groups of subjects, more often with a combination of irritable bowel syndrome with predominant constipation with functional dyspepsia, and most often with a functional disorder of the gallbladder.

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The authors declare that there are no conflicts of interest present.