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Background/Aims: Two most common functional anorectal pains, levator ani syndrome and proctalgia fugax, have a significant overlap in diagnosis and a controversy in pathogenic mechanism. Our aim was to evaluate the differences of anorectal symptoms and physiologic findings between the patients with levator ani syndrome and proctalgia fugax. Methods: Eight patients and 10 patients, who fulfilled Rome H criteria for levator ani syndrome and proctalgia fugax respectively, were evaluated for the various anorectal symptoms using questionnaire and diary, anorectal manometry, balloon defecation, and defecography. Results: Compared with patients with proctalgia fugax, the patients with levator ani syndrome showed higher percentage of symptoms of straining (87.5±30.6% vs. 40.5±44.9%, p<0.05), and tended to have higher percentage of the sensation of incomplete evacuation (88.1 ±26.4% vs. 53.0±41.9%, p=0.056). In anorectal manometric findings, squeezing pressure of the distal anal sphincter tended to be higher in patients with levator ani syndrome (201.7-±127.7 mmHg vs. 113.0±43.9 tmnHg, p=,0.056). Conclusions: Levator ani syndrome may be related to the constipation and hyper-contractile external anal sphincter, suggesting that different mechanisms may play a role in the development of anorectal pains in patients with levator ani syndrome and proctalgia fugax. (The Korean Journal of Gastrointestinal Motility 2003;9:37-41)
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