[Frequency of anorectal disorders in patients with chronic constipation, according to the London classification, in private care centers in Lima - Peru].

Abstract

Chronic constipation is a frequent gastrointestinal disorder that significantly impairs quality of life and has a multifactorial etiology. High-resolution anorectal manometry (HR-ARM) allows for an objective evaluation of anorectal function. In Peru, evidence regarding its findings in the adult population is scarce.

Objective: To describe the findings obtained through high-resolution anorectal manometry in adults with primary chronic constipation, according to the London Classification, in three private institutions in Lima, Peru.

Materials and methods: A retrospective descriptive study was conducted in three private institutions in Lima between January 2020 and December 2024. Reports of manometry from patients over 18 years old with a diagnosis of functional chronic constipation and normal colonoscopy findings were included. Data were analyzed using STATA v.18, applying descriptive statistics and the Chi-square test.

Results: A total of 122 patients were evaluated (81.2% women). According to the London Classification, the most frequent findings were anal normotension with hypocontractility (62.3%), normal expulsion with abnormal coordination (43.4%), and preserved anorectal inhibitory reflex (97.5%). Regarding rectal sensitivity, hyposensitivity was the most common finding (38.5%), followed by normal parameters (37.8%). Analysis by age and sex showed significant differences in resting anal pressure (p=0.045), desire to defecate (p=0.048), and rectal urgency (p=0.007).

Conclusions: The most frequent manometric findings in patients with primary chronic constipation were anal hypocontractility, impaired anorectal coordination, and rectal hyposensitivity. These results highlight differences according to age and sex, underscoring the importance of incorporating the London Classification to achieve a more accurate diagnosis and personalized clinical management.