Anorectal Disorders Exhibiting Pathologic Defecograms (cont.)

• Defecography is difficult to perform in incontinent patients because they are unable to retain the barium paste while going from the stretcher to the commode.

• Classically in this condition, defecography shows an open anal canal due to anal sphincter hypotonia and an abnormally increased ARA (>130°) due to a hypotonic puborectalis muscle.

• However, several studies indicate that incontinent patients may or may not have an abnormally increased ARA at rest or an abnormal excursion of the anorectal junction.