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Rectoanal reflexes and sensorimotor response in rectal hyposensitivity.
Dis Colon Rectum. 2010 Jul; 53(7):1047-54.DC

Abstract

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+Show Affiliations

Digestive Physiology and Motility Department, Medical-Biological Research Institute, Universidad Veracruzana, Veracruz, Mexico.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20551758

Citation

Remes-Troche, Jose M., et al. "Rectoanal Reflexes and Sensorimotor Response in Rectal Hyposensitivity." Diseases of the Colon and Rectum, vol. 53, no. 7, 2010, pp. 1047-54.
Remes-Troche JM, De-Ocampo S, Valestin J, et al. Rectoanal reflexes and sensorimotor response in rectal hyposensitivity. Dis Colon Rectum. 2010;53(7):1047-54.
Remes-Troche, J. M., De-Ocampo, S., Valestin, J., & Rao, S. S. (2010). Rectoanal reflexes and sensorimotor response in rectal hyposensitivity. Diseases of the Colon and Rectum, 53(7), 1047-54. https://doi.org/10.1007/DCR.0b013e3181dcb2d6
Remes-Troche JM, et al. Rectoanal Reflexes and Sensorimotor Response in Rectal Hyposensitivity. Dis Colon Rectum. 2010;53(7):1047-54. PubMed PMID: 20551758.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rectoanal reflexes and sensorimotor response in rectal hyposensitivity. AU - Remes-Troche,Jose M, AU - De-Ocampo,Sherrie, AU - Valestin,Jessica, AU - Rao,Satish S C, PY - 2010/6/17/entrez PY - 2010/6/17/pubmed PY - 2010/7/16/medline SP - 1047 EP - 54 JF - Diseases of the colon and rectum JO - Dis. Colon Rectum VL - 53 IS - 7 N2 - 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. SN - 1530-0358 UR - https://www.unboundmedicine.com/medline/citation/20551758/Rectoanal_reflexes_and_sensorimotor_response_in_rectal_hyposensitivity_ L2 - http://dx.doi.org/10.1007/DCR.0b013e3181dcb2d6 DB - PRIME DP - Unbound Medicine ER -