| Role of the rectosigmoidal junction in fecal continence: concept of the primary continent mechanism. | |
| | |
MedLine Citation:
|
PMID: 16415407 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
HYPOTHESIS: At mass contraction of the descending colon, the colonic contents stop at the sigmoid colon (SC) and do not pass directly to the rectum. We investigated the hypothesis that a continent mechanism seems to exist at the rectosigmoidal junction (RSJ), preventing the direct passage of stools from the descending colon to the rectum. METHODS: The SC in 16 healthy volunteers (mean +/- SD age, 38.6 +/- 10.2 years; 9 men and 7 women) was distended with an isotonic sodium chloride solution-filled balloon, and the pressure response of the RSJ and the rectum was recorded at rapid and gradual filling of the balloon. The test was repeated after the SC and RSJ were anesthetized separately. RESULTS: Rapid SC balloon distension with a mean +/- SD of 52.1 +/- 3.6 mL of isotonic sodium chloride solution effected an RSJ pressure increase to a mean +/- SD of 67.8 +/- 18.4 cm H(2)O (P<.01) with no rectal pressure response (P>.05). Slow SC filling produced a progressive increase in RSJ pressure but no rectal pressure change. At a mean +/- SD SC distending volume of 86.3 +/- 4.1 mL, the RSJ pressure decreased to 9.6 +/- 2.8 (P<.01), and the balloon was dispelled to the rectum; rectal pressure increased (P<.001), and the balloon was expelled to the exterior. The RSJ pressure did not respond to distension of the anesthetized SC. CONCLUSIONS: Contraction of the RSJ at rapid SC distension with big volumes implies a reflex relationship that we call the RSJ guarding reflex. This reflex seems to prevent the descending colon contents from passing directly to the rectum. It is considered the first continent reflex and may serve as an investigative tool in the study of fecal incontinence. |
| | |
Authors:
|
Ahmed Shafik; Ali A Shafik; Olfat El Sibai; Ismail Ahmed; Randa M Mostafa |
Related Documents
:
|
8317407 - Postoperative motor function and mucosal blood flow of lower esophagus: comparison betw... 8027617 - The trigger for rectal filling sensation. 3049057 - Papillary stenosis. 21274107 - The physician's approach to hypertension in the office. 3104817 - Experimental carbon dioxide laser brain lesions and intracranial dynamics: part 3. effe... 7631867 - Regulation of membrane potential and diameter by voltage-dependent k+ channels in rabbi... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Archives of surgery (Chicago, Ill. : 1960) Volume: 141 ISSN: 0004-0010 ISO Abbreviation: Arch Surg Publication Date: 2006 Jan |
Date Detail:
|
Created Date: 2006-01-17 Completed Date: 2006-02-07 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9716528 Medline TA: Arch Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 23-6 Citation Subset: AIM; IM |
Affiliation:
|
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, 2 Talaat Harb Street, Cairo 11121, Egypt. shafik@ahmedshafik.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Colon / physiology Colon, Sigmoid / physiology* Defecation / physiology* Female Humans Male Middle Aged Muscle Contraction Pressure Rectum / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Changes in breathing control and mechanics after laparoscopic vs open cholecystectomy.
Next Document: Creating arteriovenous fistulas in 132 consecutive patients: exploiting the proximal radial artery a...