Document Detail


Rectoanal reflexes and sensorimotor response in rectal hyposensitivity.
MedLine Citation:
PMID:  20551758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Rectal hyposensitivity commonly causes anorectal disorders, but its underlying mechanism is unknown. We hypothesized that subjects with rectal hyposensitivity have altered rectoanal reflexes and/or sensorimotor response.
METHODS: We performed stepwise graded balloon distensions of the rectum in 30 subjects with constipation and rectal hyposensitivity and in 23 healthy controls. Thresholds for first sensation, desire, and urgency to defecate were assessed. The lowest balloon volume that evoked rectoanal inhibitory reflex, rectoanal contractile reflex, and sensorimotor response and manometric characteristics and rectal compliance were examined.
RESULTS: Reflex responses were present in all subjects. The balloon volumes were higher in subjects with rectal hyposensitivity for inducing rectoanal inhibitory reflex (P = .008) and contractile reflex (P = .001) compared with controls. All controls showed a sensorimotor response, but in 13 hyposensitive subjects (43%) the onset of sensorimotor response was associated with absent sensation and in 17 (57%), with a transient rectal sensation. Thresholds for eliciting sensorimotor response were similar between patients and controls, but the amplitude, duration, and magnitude of response were higher (P < .05) in patients. Rectal compliance was similar between controls and hyposensitive subjects with transient sensation but higher (P = .001) in subjects with absent sensation.
CONCLUSIONS: Constipated subjects with rectal hyposensitivity demonstrate higher thresholds for inducing rectoanal reflexes and abnormal characteristics of sensorimotor response. These findings suggest either disruption of afferent gut-brain pathways or rectal wall dysfunction. These altered features may play a role in the pathogenesis of bowel dysfunction in rectal hyposensitivity.
Authors:
Jose M Remes-Troche; Sherrie De-Ocampo; Jessica Valestin; Satish S C Rao
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  53     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-16     Completed Date:  2010-07-15     Revised Date:  2014-02-28    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1047-54     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Afferent Pathways / physiopathology*
Anal Canal / innervation*,  physiopathology
Catheterization
Compliance
Constipation / diagnosis,  physiopathology*
Female
Humans
Male
Manometry
Middle Aged
Rectal Diseases / physiopathology*
Rectum / innervation*,  physiopathology
Reflex, Abnormal*
Sensation / physiology
Somatosensory Disorders / diagnosis,  physiopathology*
Grant Support
ID/Acronym/Agency:
R01 DK057100/DK/NIDDK NIH HHS; R01DK 57100-03/DK/NIDDK NIH HHS
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