Quality Of Life After Operation And The Expression Of TRPV1,5-HT In The Rectal Mucosal Layer Of Patients With Internal Rectal Prolapse

ObjectiveInternal rectal prolapse (IRP) is the most common type of outlet obstructiveconstipation (OOC), which seriously affect the patients’ health and quality of life. There israrely reported about how improvement of quality of life after surgery. This study aims tostudy the improvement of quality of life after operation. In addition, the pathophysiologyof IRP is unclear, although there are various clinical treatments for IRP, larger differences intreatment effect. Recent study showed that sensory nerve-mediated regulation of transientreceptor potential vanilloid1(TRPV1) and serotonin(5-HT) play an important role inintestinal motility disorders. Therefore, this study will observe the changes of TRPV1and5-HT in the rectal mucosal layer of patients with IRP and preliminary study the role ofchange in sensory signal molecules within rectal mucosa in the pathogenesis of IRP.Methods:52patients diagnosised with IRP and surgury in last five years from daping hospitalstomach colorectal&anal surgery were classified as research objects.34patients followedup after operation is taken as postoperative group, comparing their quality of life before andafter operation by gastrointestinal quality of life questionnaire(GIQLI), Wexnerconstipation(WC), the MOS item short from health survey(SF–36) and comparativeanalysis of the quality of life improvement,9of34patients agreed to back to hospital toreview.20patients were diagnosed with IRP by defecography and given conservativetreatment from daping hospital stomach colorectal&anal surgery from october to decemberin2012as non operation group;20healthy physical examination people were taken at thesame time as control group. Checking their rectal compaliance of the initial feeling volumeand maximum tolerance capacity in rectum, the expression of TRPV1and5-HT in thelower rectal mucosa from9cases of postoperative group and20cases non operation with IRP,and20cases from the control group. All subjects signed the informed consent beforechecked.ResultAll34patients followed up successfully filled their form of GIQLI, WC and SF-36quality of life questionnaire from52cases of postoperative followed up group with IRP. Asa result, the statistical analysis showed significantly improvement of gastrointestinal qualityof life after operation(P<0.01); Constipation is improved significantly after operation forpatients with IRP(P<0.01); All aspects(including physiology, body pain, social function,general health, mental health, physiological functioning, vitality and emotional function)are highly imoroved after operation for patients with IRP(P<0.01). For9postoperativepatients,20non operation patients with IRP and20healthy people from control group, theinitial feeling of rectal volume of postoperative group is significantly improved than nonoperation group and control group, and this feeling of non operation group is also higher forpatients with IRP more than the control group(P<0.01). Compared to the control group, themaximum tolerated sensation volume of postoperative group has no significant difference(P>0.05), but it is higher than the non operation group (P<0.01). Compared to the nonoperation group, the maximum tolerated sensation volume of control group is improvedsignificantly(P<0.01): Rectal compaliance of the non operation group is lower less than thecontrol group. Checking the expression of TRPV1and5-HT in the lower rectal mucosa, theimmunoreactivity of expression in the non operation group is higher significantly than thepostoperative group and the control group(P<0.01), but immunoreactivity has no significantdifference between the postoperative group and the control group(P>0.05).ConclusionThrough this study, we found that although the efficacy of surgery for patients withIRP are different, the quality of life after operation in the patients with IRP includinggastrointestinal quality of life, constipation, general condition, social function and physicalcondition is improved significantly, surgery for patients with IRP remains an effectivetreatment. In our opinion, excess expression of TRPV1and5-HT in the lower rectal mucosacauses the rectal sensory dysfunction, which decreased the rectal compliance of patientswith IRP.