Tags

Type your tag names separated by a space and hit enter

Gut symptoms in diabetics correlate with components of the rectoanal inhibitory reflex, but not with pudendal nerve motor latencies or systemic autonomic neuropathy.
J Dig Dis. 2015 Jun; 16(6):342-9.JD

Abstract

OBJECTIVE

Fecal incontinence (FI) occurs in up to 20% of diabetes mellitus (DM) patients. Rectoanal inhibitory reflex (RAIR) is an enteric anorectal reflex that reflects the integrity of mechanisms in the physiology of FI. We aimed to investigate whether diabetic patients with FI, not constipation, had prolongation of RAIR and altered gut-specific autonomic tone.

METHODS

In this prospective case-matched study 31 type I DM (19 FI and 12 constipation) and 42 type II DM (26 FI and 16 constipation). Another 21 participants were included as controls. Patients underwent the following assessments: cardiovagal autonomic tone (Modified Mayo Clinic composite autonomic severity score), rectal mucosal blood flow (RMBF) (assessment of gut-specific autonomic tone) and RAIR. Three phases of RAIR and the amplitude of maximal reflex relaxation were compared between groups. All participants completed symptom scores for FI and constipation.

RESULTS

RAIR recovery time back to resting pressure was slower in diabetic patients with FI than controls (8.7 s vs 3.6 s, P < 0.05) and was an independent variable correlating with symptoms of FI (P < 0.05). RAIR recovery time was correlated with RMBF (r = 0.58, P = 0.04).

CONCLUSION

RAIR is correlated with anorectal symptoms of FI and was associated with gut-specific autonomic neuropathy.

Authors+Show Affiliations

Physiology Unit, Department of Gastroenterology, University College Hospital London, London, UK. Department of Surgery, University of Adelaide, Adelaide, South Australia, Australia.Physiology Unit, Department of Gastroenterology, University College Hospital London, London, UK.Department of Surgery, University of Adelaide, Adelaide, South Australia, Australia.Department of Gastroenterology, Royal Free Hospital, London, UK.Physiology Unit, Department of Gastroenterology, University College Hospital London, London, UK.Physiology Unit, Department of Gastroenterology, University College Hospital London, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25761939

Citation

Thiruppathy, Kumaran, et al. "Gut Symptoms in Diabetics Correlate With Components of the Rectoanal Inhibitory Reflex, but Not With Pudendal Nerve Motor Latencies or Systemic Autonomic Neuropathy." Journal of Digestive Diseases, vol. 16, no. 6, 2015, pp. 342-9.
Thiruppathy K, Bajwa A, Kuan KG, et al. Gut symptoms in diabetics correlate with components of the rectoanal inhibitory reflex, but not with pudendal nerve motor latencies or systemic autonomic neuropathy. J Dig Dis. 2015;16(6):342-9.
Thiruppathy, K., Bajwa, A., Kuan, K. G., Murray, C., Cohen, R., & Emmanuel, A. (2015). Gut symptoms in diabetics correlate with components of the rectoanal inhibitory reflex, but not with pudendal nerve motor latencies or systemic autonomic neuropathy. Journal of Digestive Diseases, 16(6), 342-9. https://doi.org/10.1111/1751-2980.12244
Thiruppathy K, et al. Gut Symptoms in Diabetics Correlate With Components of the Rectoanal Inhibitory Reflex, but Not With Pudendal Nerve Motor Latencies or Systemic Autonomic Neuropathy. J Dig Dis. 2015;16(6):342-9. PubMed PMID: 25761939.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gut symptoms in diabetics correlate with components of the rectoanal inhibitory reflex, but not with pudendal nerve motor latencies or systemic autonomic neuropathy. AU - Thiruppathy,Kumaran, AU - Bajwa,Adeel, AU - Kuan,Kean Guan, AU - Murray,Charles, AU - Cohen,Richard, AU - Emmanuel,Anton, PY - 2015/3/13/entrez PY - 2015/3/13/pubmed PY - 2016/4/20/medline KW - anorectal physiology KW - constipation KW - diabetes mellitus KW - fecal incontinence KW - rectoanal inhibitory reflex SP - 342 EP - 9 JF - Journal of digestive diseases JO - J Dig Dis VL - 16 IS - 6 N2 - OBJECTIVE: Fecal incontinence (FI) occurs in up to 20% of diabetes mellitus (DM) patients. Rectoanal inhibitory reflex (RAIR) is an enteric anorectal reflex that reflects the integrity of mechanisms in the physiology of FI. We aimed to investigate whether diabetic patients with FI, not constipation, had prolongation of RAIR and altered gut-specific autonomic tone. METHODS: In this prospective case-matched study 31 type I DM (19 FI and 12 constipation) and 42 type II DM (26 FI and 16 constipation). Another 21 participants were included as controls. Patients underwent the following assessments: cardiovagal autonomic tone (Modified Mayo Clinic composite autonomic severity score), rectal mucosal blood flow (RMBF) (assessment of gut-specific autonomic tone) and RAIR. Three phases of RAIR and the amplitude of maximal reflex relaxation were compared between groups. All participants completed symptom scores for FI and constipation. RESULTS: RAIR recovery time back to resting pressure was slower in diabetic patients with FI than controls (8.7 s vs 3.6 s, P < 0.05) and was an independent variable correlating with symptoms of FI (P < 0.05). RAIR recovery time was correlated with RMBF (r = 0.58, P = 0.04). CONCLUSION: RAIR is correlated with anorectal symptoms of FI and was associated with gut-specific autonomic neuropathy. SN - 1751-2980 UR - https://www.unboundmedicine.com/medline/citation/25761939/Gut_symptoms_in_diabetics_correlate_with_components_of_the_rectoanal_inhibitory_reflex_but_not_with_pudendal_nerve_motor_latencies_or_systemic_autonomic_neuropathy_ L2 - https://doi.org/10.1111/1751-2980.12244 DB - PRIME DP - Unbound Medicine ER -