Tags

Type your tag names separated by a space and hit enter

Spectrum of abnormal rectoanal reflex patterns in patients with fecal incontinence.
Dis Colon Rectum. 1996 Jan; 39(1):59-65.DC

Abstract

PURPOSE

Abnormalities of rectoanal inhibitory or excitatory reflex in patients with fecal incontinence are well described. A spectrum of abnormal responses, other than those already described in the literature, has been observed in some patients with fecal incontinence and forms the subject of this report.

METHOD

Forty-three patients with idiopathic or traumatic fecal incontinence were studied to evaluate their reflex responses to balloon distention of the rectum, and results were compared with reflex responses of 29 control subjects with no anorectal complaints.

RESULTS

Control subjects revealed normal reflex responses consisting of initial excitation followed by inhibition in the proximal anal canal and an excitatory response in the distal anal canal. Patients who were incontinent revealed five different types of reflex patterns. Eleven patients (25.5 percent) with segmental sphincter defects from obstetric injuries exhibited no distal excitation but had normal response in the proximal anal canal (Group 1). Eleven patients (25.5 percent) with idiopathic incontinence exhibited normal proximal response but an inhibitory as opposed to excitatory response in the distal anal canal (Group 2). Three patients (7 percent) with iatrogenic trauma failed to register an excitatory response in the proximal or distal anal canal but revealed a normal inhibitory reflex (Group 3). Nine patients (21 percent) with idiopathic incontinence revealed excitatory response in the entire anal canal but no inhibition (Group 4). Nine patients (21 percent) with idiopathic incontinence had a normal reflex pattern (Group 5).

CONCLUSION

Excitatory and inhibitory components of rectoanal reflexes may selectively be abolished in neurogenic or traumatic insults to visceral and somatic anal sphincters, resulting in altered rectoanal reflex patterns.

Authors+Show Affiliations

Department of Colon and Rectal Surgery, Lahey Clinic, Burlington, Massachusetts 01805, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8601359

Citation

Sangwan, Y P., et al. "Spectrum of Abnormal Rectoanal Reflex Patterns in Patients With Fecal Incontinence." Diseases of the Colon and Rectum, vol. 39, no. 1, 1996, pp. 59-65.
Sangwan YP, Coller JA, Schoetz DJ, et al. Spectrum of abnormal rectoanal reflex patterns in patients with fecal incontinence. Dis Colon Rectum. 1996;39(1):59-65.
Sangwan, Y. P., Coller, J. A., Schoetz, D. J., Roberts, P. L., & Murray, J. J. (1996). Spectrum of abnormal rectoanal reflex patterns in patients with fecal incontinence. Diseases of the Colon and Rectum, 39(1), 59-65.
Sangwan YP, et al. Spectrum of Abnormal Rectoanal Reflex Patterns in Patients With Fecal Incontinence. Dis Colon Rectum. 1996;39(1):59-65. PubMed PMID: 8601359.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spectrum of abnormal rectoanal reflex patterns in patients with fecal incontinence. AU - Sangwan,Y P, AU - Coller,J A, AU - Schoetz,D J, AU - Roberts,P L, AU - Murray,J J, PY - 1996/1/1/pubmed PY - 1996/1/1/medline PY - 1996/1/1/entrez SP - 59 EP - 65 JF - Diseases of the colon and rectum JO - Dis. Colon Rectum VL - 39 IS - 1 N2 - PURPOSE: Abnormalities of rectoanal inhibitory or excitatory reflex in patients with fecal incontinence are well described. A spectrum of abnormal responses, other than those already described in the literature, has been observed in some patients with fecal incontinence and forms the subject of this report. METHOD: Forty-three patients with idiopathic or traumatic fecal incontinence were studied to evaluate their reflex responses to balloon distention of the rectum, and results were compared with reflex responses of 29 control subjects with no anorectal complaints. RESULTS: Control subjects revealed normal reflex responses consisting of initial excitation followed by inhibition in the proximal anal canal and an excitatory response in the distal anal canal. Patients who were incontinent revealed five different types of reflex patterns. Eleven patients (25.5 percent) with segmental sphincter defects from obstetric injuries exhibited no distal excitation but had normal response in the proximal anal canal (Group 1). Eleven patients (25.5 percent) with idiopathic incontinence exhibited normal proximal response but an inhibitory as opposed to excitatory response in the distal anal canal (Group 2). Three patients (7 percent) with iatrogenic trauma failed to register an excitatory response in the proximal or distal anal canal but revealed a normal inhibitory reflex (Group 3). Nine patients (21 percent) with idiopathic incontinence revealed excitatory response in the entire anal canal but no inhibition (Group 4). Nine patients (21 percent) with idiopathic incontinence had a normal reflex pattern (Group 5). CONCLUSION: Excitatory and inhibitory components of rectoanal reflexes may selectively be abolished in neurogenic or traumatic insults to visceral and somatic anal sphincters, resulting in altered rectoanal reflex patterns. SN - 0012-3706 UR - https://www.unboundmedicine.com/medline/citation/8601359/Spectrum_of_abnormal_rectoanal_reflex_patterns_in_patients_with_fecal_incontinence_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=8601359.ui DB - PRIME DP - Unbound Medicine ER -