Existence of a high pressure zone at the rectosigmoid junction in normal Indian men

Wadhwa, Rajkumar P.; Mistry, F P; Bhatia, Shobna; Abraham, Philip

doi:10.1007/bf02081412

Cited by 16 publications

(12 citation statements)

References 9 publications

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“…The mucosal folds were abundant, adding further to a sphincteric function. The presence of such a sphincter could explain the high-pressure zone existing in the SRC (Wadhwa et al, 1996;Shafik, 1997Shafik, , 1998 as well as the physiologic responses occurring in this area (Shafik, 1996(Shafik, , 1999.…”

Section: Discussionmentioning

confidence: 99%

“…Since then, however, other investigators have denied the existence of a rectosigmoid sphincter (Goligher et al, 1984;Stoss, 1990). Recent studies (Wadhwa et al, 1996;Shafik, 1997Shafik, , 1998 have shown that the RSJ has a higher pressure than either the sigmoid colon (SC) or rectum. In addition, its response by relaxation or contraction upon SC or rectal contractions, respectively, suggests the presence of a physiologic sphincter at the RSJ (Shafik, 1996(Shafik, , 1999.…”

Section: Introductionmentioning

confidence: 99%

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Identification of a sphincter at the sigmoidorectal canal in humans: Histomorphologic and morphometric studies

2003

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In a recent study we demonstrated that the rectosigmoid junction is a large bowel segment 2.8 +/- 0.9 cm in length, which we have termed the 'sigmoidorectal canal' (SRC). In that study we showed that the SRC exerted increased intraluminal pressure, contained a thick, circular, smooth muscle layer, and reacted to sigmoid colon (SC) and rectal contraction by relaxation and contraction, respectively. These findings suggest the existence of an anatomical sphincter at the SRC. To investigate this hypothesis, in the present study we carried out a morphometric (quantitative) analysis of the musculature of the SC, SRC, and rectum. Twenty-two cadavers (13 male, 9 female; mean age = 32.3 +/- 17.6 years) were investigated. Histomorphologic studies comprised staining transverse (15 cadavers) and longitudinal (7 cadavers) sections from the SC, SRC, and rectum. Specimens were stained with H&E, Masson's trichrome, and silver stains. Morphometric studies, using image analyzer computer equipment, measured the muscle thickness of the muscularis externa (ME) of the SC, SRC, and rectum. The ME of the SRC was markedly thickened compared to the ME of the SC or rectum. In 16 specimens, the increased thickness involved mainly the circular muscle layer and in six specimens both the circular and longitudinal layers. Connective tissue septa connected the adventitia with the submucosa: these 'adventitial septa' contained nerve ganglia. 'Localized bundles' of smooth muscle fibers were detected between the circular muscle fibers. The morphometric findings showed that the mean thickness of the circular muscle layer measured 440.3 +/- 80.1 microm in the SC, 1166.1 +/- 255.4 microm in the SRC, and 394.9 +/- 123.9 microm in the rectum. This study strongly suggests the presence of an anatomic sphincter at the SRC. This sphincter may explain the higher pressure at the SRC and the response of the SRC to rectal and SC contractions. The localized smooth muscle bundles in the ME may represent a rectosigmoid pacemaker.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Identification of a sphincter at the sigmoidorectal canal in humans: Histomorphologic and morphometric studies

2003

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“…The presence of a sphincter between the sigmoid and the rectum (the recto-sigmoid sphincter of O'Beirne) [161] has long been debated. Although the evidence of a convincing anatomical sphincter is lacking, a high-pressure zone with unique contractile properties (in response to sigmoid and rectal distension/contraction) has been shown in the distal sigmoid, which supports the idea of a physiological sphincter [161][162][163][164]. The role of the recto-sigmoid junction in normal defecation is still unclear.…”

Section: Colonic Motor Activitymentioning

confidence: 91%

The Physiology of Human Defecation

2012

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“…1999), and we designated it the rectosigmoid canal (RSC). The RSC pressure was higher than that in the sigmoid colon (SC) or rectum (R) (Shafik, 1996, 1999; Wadhwa et al. 1996).…”

Section: Introductionmentioning

confidence: 97%

“…Stoss (1990) reported that the rectosigmoid junction is not a true sphincter though it may be regarded as a functional one. Ballantyne (1986) and Wadhwa et al. (1996) stated that approximately 40–50% of normal men have a high pressure zone at the rectosigmoid junction.…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological study of the rectosigmoid canal: evidence of a rectosigmoid sphincter

2002

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Previous studies strongly suggest the presence of a sphincter at the rectosigmoid junction, an area with a mean length of 2.8 cm in adults, called the rectosigmoid canal (RSC). To find supporting evidence of a sphincteric function for the RSC, two recording electrodes were applied to each of the sigmoid colon (SC), RSC and rectum (R) in 11 subjects during operative repair of huge incisional hernias. The RSC, SC and R were individually stimulated by a further electrode and their pressures monitored by a three-channel microtip catheter. The variables of the slow waves or pacesetter potentials, recorded at rest from the RSC and R, were significantly higher than those of the SC. While the frequency and conduction velocity of pacesetter potentials of the RSC and R were similar, the potential pacesetter amplitude of the RSC was significantly higher. The increase of the electrical activity and pressure upon electrostimulation was significantly greater in the RSC than that of the SC or R. Electrostimulation led to an increase in pressure of all three areas, the RSC increase being significantly the greatest. The greater increase of the electrical activity and pressure of the rectosigmoid canal upon electrostimulation, compared to that of the SC or R, strongly supports the presence of a rectosigmoid sphincter.

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Existence of a high pressure zone at the rectosigmoid junction in normal Indian men

Abstract: Approximately one-half of normal Indian men with regular bowel habits have a high pressure zone in the rectosigmoid region. The role of diet or defecation posture in its etiology and its effect on bowel habit need to be studied.

Cited by 16 publications

References 9 publications

Identification of a sphincter at the sigmoidorectal canal in humans: Histomorphologic and morphometric studies

Identification of a sphincter at the sigmoidorectal canal in humans: Histomorphologic and morphometric studies

The Physiology of Human Defecation

Electrophysiological study of the rectosigmoid canal: evidence of a rectosigmoid sphincter

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