Document Detail


Determinants of fecal continence in healthy, continent subjects: a comprehensive analysis by anal manometry, rectal barostat and a stool substitute retention test.
MedLine Citation:
PMID:  20847563     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND/AIMS: This study aimed to identify anal sphincter and rectal factors that determine anorectal filling sensations and continence during rectal filling in health.
METHODS: Measurements of anorectal physiology were collected from 42 continent healthy subjects participating in a prospective trial. Rectal function and capacity were assessed by barostat. Anal sphincter functions were assessed by manometry. A validated stool substitute retention test was performed in which a viscous suspension was infused into the rectum at 60 ml/min to 1,500 ml. Multivariate regression was applied to identify physiologic factors that determine anorectal sensation and continence during rectal filling.
RESULTS: The volume at which first awareness of rectal filling occurred associated with age (p < 0.03), rectal capacity (p < 0.06) and anal resting pressure (p < 0.003); urgency associated with rectal capacity (p < 0.0007), anal resting (p < 0.04) and squeeze pressure (p < 0.02); volume at first incontinence with rectal capacity (p < 0.0001) and squeeze pressure (p < 0.04) and the maximum volume retained were closely correlated with rectal capacity only (p < 0.0001).
CONCLUSION: Anorectal filling sensations and continence in health require a rectal reservoir of adequate capacity and effective voluntary anal sphincter function. Complementary associations between continence, motor and sensory function indicate the presence of an adaptive mechanism that enables timely, appropriate responses to events that threaten fecal continence.
Authors:
Mark Fox; Miriam Thumshirn; Heiko Frühauf; Michael Fried; Werner Schwizer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-18
Journal Detail:
Title:  Digestion     Volume:  83     ISSN:  1421-9867     ISO Abbreviation:  Digestion     Publication Date:  2011  
Date Detail:
Created Date:  2010-11-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150472     Medline TA:  Digestion     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  46-53     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Affiliation:
Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. mark.fox@nottingham.ac.uk
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