Physiology and Pathophysiology of Anal Function

Rasmussen, Ole F.; Christiansen, John

doi:10.3109/00365529609094571

Cited by 14 publications

(6 citation statements)

References 47 publications

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“…The IAS is persistently tonically contracted and participates in the act of defecation by reflex relaxation in response to rectal distension known as the recto‐anal inhibitory reflex 5 . The EAS with the puborectalis muscles are mainly responsible for the squeezing pressure as a response to voluntary effort, or induced by increased intra‐abdominal pressure during coughing and sneezing 6,7 …”

Section: Introductionmentioning

confidence: 99%

Evaluation of anal sphincter resistance and distensibility in healthy controls using EndoFLIP ©

Alqudah

Gregersen²,

Drewes

et al. 2012

Neurogastroenterology Motil

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Section: Introductionmentioning

confidence: 99%

Evaluation of anal sphincter resistance and distensibility in healthy controls using EndoFLIP ©

Alqudah

Gregersen²,

Drewes

et al. 2012

Neurogastroenterology Motil

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“…Inflammation, rectal ischemia, anorectal lesions and melanosis coli were noted if present. 17,29 Pathological ®ndings were photographed. A total of 35 CTT, 34 anorectal manometries and 36 recto-colonoscopies were performed on 38 patients.…”

Section: Methodsmentioning

confidence: 99%

Clinical evaluation and management of neurogenic bowel after spinal cord injury

Correa

Rotter

2000

Spinal Cord

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Objectives: To assess the state of the neurological bowel in spinal cord injured (SCI) patients, design and apply a program for the comprehensive management of neurogenic bowel and evaluate outcome. Setting: Out-patient in a Rehabilitation Service. Subjects: Thirty-eight SCI patients, 12 (32%) with complete lesions of more than 5 years duration. Design: Observational, longitudinal and prospective. Pre and post intervention. Method: Pre and post SCI intestinal function was evaluated clinically prior to beginning program. The presence of GI symptoms were studied. Laboratory work-up included colonic transit time (CTT), anorectal manometry and recto-colonoscopy. An intestinal program was designed, in order to achieve an eective and ecient evacuation in a predictable and socially acceptable time, to avoid short and long term complications and eliminate inadequate intestinal evacuation habits. Outcome measures: Pre and post SCI diculty in intestinal evacuation (DIE) was increased (from 2.6% to 26.3%). The most frequent GI symptom was abdominal distention (53%). Colonic inertia was present in 49% of CTT, internal anal sphincter pressure was normal or increased in 77% and rectoanal inhibitory re¯ex was present in 88%. With the intestinal program, the incidence of DIE was reduced to 8.8%, manual extraction (ME) was reduced from 53% to 37%. Excellent and good results were obtained in 56% of the patients. Conclusion: The proposed intestinal program is eective in the rehabilitation of SCI patients with neurogenic bowel. It is essential to initiate these physiological and safe procedures as soon as possible after sustaining the injury; this will lead to better results and to the elimination of inadequate intestinal maneuvering in the future. Spinal Cord (2000) 38, 301 ± 308

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“…Dysfunctional defecation may be due to lack of relaxation of the internal anal sphincter or the striated muscles of the pelvic floor, or paradoxical contraction of the external anal sphincter and/or the puborectalis muscle during straining to defecate. Furthermore, disorders of rectal sensation and ignoring or resisting the physiological urge to defecate lead to fecal impaction and obstructed defecation 22,23 . Patterns of abnormalities leading to obstructed defecation can best be understood by knowledge of the anorectal anatomy and physiology of defecation.…”

Section: Pathophysiologymentioning

confidence: 99%

Constipation of anorectal outlet obstruction: Pathophysiology, evaluation and management

Andromanakos

Skandalakis

Troupis

et al. 2006

J of Gastro and Hepatol

138

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Constipation is a subjective symptom of various pathological conditions. Incidence of constipation fluctuates from 2 to 30% in the general population. Approximately 50% of constipated patients referred to tertiary care centers have obstructed defecation constipation. Constipation of obstructed defecation may be due to mechanical causes or functional disorders of the anorectal region. Mechanical causes are related to morphological abnormalities of the anorectum (megarectum, rectal prolapse, rectocele, enterocele, neoplasms, stenosis). Functional disorders are associated with neurological disorders and dysfunction of the pelvic floor muscles or anorectal muscles (anismus, descending perineum syndrome, Hirschsprung's disease). However, this type of constipation should be differentiated by colonic slow transit constipation which, if coexists, should be managed to a second time. Assessment of patients with severe constipation includes a good history, physical examination and specialized investigations (colonic transit time, anorectal manometry, rectal balloon expulsion test, defecography, electromyography), which contribute to the diagnosis and the differential diagnosis of the cause of the obstructed defecation. Thereby, constipated patients can be given appropriate treatment for their problem, which may be conservative (bulk agents, high-fiber diet or laxatives), biofeedback training or surgery.

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Physiology and Pathophysiology of Anal Function

Cited by 14 publications

References 47 publications

Evaluation of anal sphincter resistance and distensibility in healthy controls using EndoFLIP ©

Evaluation of anal sphincter resistance and distensibility in healthy controls using EndoFLIP ©

Clinical evaluation and management of neurogenic bowel after spinal cord injury

Constipation of anorectal outlet obstruction: Pathophysiology, evaluation and management

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