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Clinical significance of quantitative assessment of rectoanal inhibitory reflex (RAIR) in patients with constipation.
J Clin Gastroenterol. 2008 Jul; 42(6):692-8.JC

Abstract

BACKGROUND

Rectoanal inhibitory reflex (RAIR) is routinely assessed in anorectal manometry and is of clinical value in the diagnosis of patients with constipation. However, no quantitative analysis is currently available for the assessment of RAIR. The aim of this study was to evaluate the diagnostic value of quantitative assessment of RAIR in patients with constipation.

METHODS

Nine healthy subjects, 22 constipation patients (CO) and 26 fecal incontinence patients (FI) were enrolled in this study. RAIR was solicited by inflating the balloon with various volumes from 10 to 50 mL. The percentage of relaxation was determined on the basis of the rectal resting sphincter pressure and residual pressure with the balloon distention.

RESULTS

Percentage of internal sphincter relaxation induced by rectal distention in constipation patients was significantly lower with distention of 20, 30, 40, and 50 mL in comparison with that in healthy subjects (Mixed model, P<0.05). The volume of distention required to achieve a relaxation of 50% was significantly higher in patients with CO (37.3+/-3.1 mL) than that in healthy subjects (27.8+/-2.6 mL, P<0.03) or FI (26.3+/-2.3 mL, P<0.05). It was also found that the percentage of relaxation could be used to differentiate the patients with constipation with a specificity of 64% and a sensitivity of 67%.

CONCLUSIONS

Patients with CO have impaired RAIR in comparison with healthy subjects and patients with FI. Quantitative assessment of RAIR is valuable in the diagnosis of patients with CO and may be incorporated in the clinical anorectal manometric test.

Authors+Show Affiliations

Division of Gastroenterology, University of Texas Medical Branch, Galveston, TX, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

18496393

Citation

Xu, Xiaohong, et al. "Clinical Significance of Quantitative Assessment of Rectoanal Inhibitory Reflex (RAIR) in Patients With Constipation." Journal of Clinical Gastroenterology, vol. 42, no. 6, 2008, pp. 692-8.
Xu X, Pasricha PJ, Sallam HS, et al. Clinical significance of quantitative assessment of rectoanal inhibitory reflex (RAIR) in patients with constipation. J Clin Gastroenterol. 2008;42(6):692-8.
Xu, X., Pasricha, P. J., Sallam, H. S., Ma, L., & Chen, J. D. (2008). Clinical significance of quantitative assessment of rectoanal inhibitory reflex (RAIR) in patients with constipation. Journal of Clinical Gastroenterology, 42(6), 692-8. https://doi.org/10.1097/MCG.0b013e31814927ba
Xu X, et al. Clinical Significance of Quantitative Assessment of Rectoanal Inhibitory Reflex (RAIR) in Patients With Constipation. J Clin Gastroenterol. 2008;42(6):692-8. PubMed PMID: 18496393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical significance of quantitative assessment of rectoanal inhibitory reflex (RAIR) in patients with constipation. AU - Xu,Xiaohong, AU - Pasricha,Pankaj J, AU - Sallam,Hanaa S, AU - Ma,Long, AU - Chen,Jiande D Z, PY - 2008/5/23/pubmed PY - 2008/10/8/medline PY - 2008/5/23/entrez SP - 692 EP - 8 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 42 IS - 6 N2 - BACKGROUND: Rectoanal inhibitory reflex (RAIR) is routinely assessed in anorectal manometry and is of clinical value in the diagnosis of patients with constipation. However, no quantitative analysis is currently available for the assessment of RAIR. The aim of this study was to evaluate the diagnostic value of quantitative assessment of RAIR in patients with constipation. METHODS: Nine healthy subjects, 22 constipation patients (CO) and 26 fecal incontinence patients (FI) were enrolled in this study. RAIR was solicited by inflating the balloon with various volumes from 10 to 50 mL. The percentage of relaxation was determined on the basis of the rectal resting sphincter pressure and residual pressure with the balloon distention. RESULTS: Percentage of internal sphincter relaxation induced by rectal distention in constipation patients was significantly lower with distention of 20, 30, 40, and 50 mL in comparison with that in healthy subjects (Mixed model, P<0.05). The volume of distention required to achieve a relaxation of 50% was significantly higher in patients with CO (37.3+/-3.1 mL) than that in healthy subjects (27.8+/-2.6 mL, P<0.03) or FI (26.3+/-2.3 mL, P<0.05). It was also found that the percentage of relaxation could be used to differentiate the patients with constipation with a specificity of 64% and a sensitivity of 67%. CONCLUSIONS: Patients with CO have impaired RAIR in comparison with healthy subjects and patients with FI. Quantitative assessment of RAIR is valuable in the diagnosis of patients with CO and may be incorporated in the clinical anorectal manometric test. SN - 1539-2031 UR - https://www.unboundmedicine.com/medline/citation/18496393/Clinical_significance_of_quantitative_assessment_of_rectoanal_inhibitory_reflex__RAIR__in_patients_with_constipation_ L2 - http://dx.doi.org/10.1097/MCG.0b013e31814927ba DB - PRIME DP - Unbound Medicine ER -