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At least 343 records · Page 19Linked to original sources
PubMed1992

Is the volume retained after defecation a valuable parameter at defecography?

The intention of this study was to correlate the retained volume at the end of defecography to certain defecographic findings and to the sense of incomplete emptying. In 170 defecographic series, the retained barium was estimated planimetrically. No particular defecographic finding determined a higher or lower amount of remaining volume, and the sense of incomplete evacuation did not depend on the amount of retained volume. Thresholds of urge and perception on anorectal manometry did not differ between patients with and without the feeling of incomplete evacuation. A rectocele, isolated or combined with an internal prolapse, caused the retained volume to be in the lowermost part of the rectum, whereas, in the case of an isolated intussusception, the remaining volume was located in the middle or higher part of the rectum. It is concluded that defecographic findings do not in general explain incomplete emptying or the sense of incomplete emptying, but they may determine the localization of the retained volume.

Adult↗
PubMed1997

Anal endosonography and manometry: comparison in patients with defecation problems.

PURPOSE: Correlations between anal sphincter function as assessed by anorectal manometry and anal sphincter anatomy measured by endoluminal ultrasound have been reported in the literature both for patients and for healthy individuals but have not been confirmed by other authors. METHODS: For a larger series of patients (152 consecutive patients, mean age 54.1 +/- 15.5 years; female:male ratio, 111:41) with anorectal dysfunctions such as incontinence (n = 92), constipation (n = 37), and other symptoms (n = 23), diagnostic work-up included conventional multilumen anorectal manometry to evaluate internal sphincter pressure at rest, maximum external sphincter squeeze pressure during contraction, and endoanal sonography to determine anal sphincter integrity and to measure dorsal, left lateral, and right lateral diameter of the internal anal sphincter (IAS) and external anal sphincter (EAS) muscles. RESULTS: Maximum squeeze pressure was significantly correlated to muscle thickness of the EAS (P = 0.001). No association was found between resting pressure and IAS diameter. Women had significantly lower resting and squeeze pressures than men (P = 0.008 and P = 0.003, respectively), but age-related changes of function were only found for resting pressure. Endosonographic values of IAS and EAS did not differ between genders but were significantly correlated with age (P = 0.008 and P = 0.02, respectively). Because all correlations were rather weak, they only can explain a small portion of data variance. CONCLUSION: Anal manometry and anal ultrasound, therefore, are of complementary value and are both indicated in adequate clinical problems.

Adult↗
PubMed1980

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. X. Anorectal sinus and band: anatomic nature and surgical significance.

A study, comprising dissection and microscopic examination of the pectinate area with special consideration to anal glands, was performed in 29 cadavers varying from fully mature neonatal deaths to 52 years of age. At the junction of the anal canal proper with the rectal neck, an "anorectal sinus" (a submucosal anal circumferential depression) was identified in 18 specimens; in 6 specimens, the anorectal sinus was replaced by a fibroepithelial band ("anorectal band"); in 5 specimens, the anorectal sinus was absent, and in 3 of the 5 specimens only scattered epithelial cells ("epithelial debris" of the anorectal sinus) were detected. These findings suggest that the anorectal sinus is an embryonic vestige which results from hindgut "invagination" by the proctodeum. Its persistence or partial obliteration would result in the formation of tubular structures which are considered by investigators as anal glands. The sinus may be completely obliterated or may leave behind a submucosal "anorectal band" or scattered "epithelial debris." Evidence in favor of this new concept is put forward. The role of anorectal sinus, anorectal band, and epithelial debris in the genesis of some idiopathic anal lesions is discussed.

Adenocarcinoma↗
PubMed1982

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. XV. Chronic anal fissure: a new theory of pathogenesis.

Pathologic changes in chronic anal fissures were studied in 52 patients. In 40 patients, epithelial cells could be identified in the fissure floor superficial to the internal anal sphincter. The cells were rounded, oval, or columnar and were arranged in clumps or pseudoacinar formations. In 10 patients the anorectal sinus was detected in the fissure floor, whereas in 2 patients no epithelial cells could be found. It seems that chronic anal fissure results from disruption of the anal lining, which exposes epithelial cells or the anorectal sinus in the wound floor to repeated infection. It is believed that these epithelial cells are just anorectal sinus remnants that exist in the submucosa of the anal canal proper as epithelial debris or anorectal band. Epithelial cells act as multiple sequestra that harbor the infection and are responsible for fissure chronicity. These patients are predisposed to anal traumatization by feces, owing to the anorectal band's constricting effect on the anal canal proper. The exclusive fissure location in the anal canal proper and not in the rectal neck is due to the anorectal sinus remnants contained therein. The posterior and, rarely, anterior median fissure position is ascribed to the existence of two weak anal areas. The break commonly occurs posteriorly because the posterior anal wall lacks sufficient support. It is concluded that fissure excision, including anorectal bandotomy, at present, is the best treatment to achieve a radical cure.

Adult↗
PubMed1989

Rectal J pouch reservoir to decrease the frequency of tenesmus and defecation in low coloproctostomy.

Low anterior resection of the colon with very low coloproctostomy is a procedure occasionally required in the surgical management of the patient with gynecologic malignancy. Very low end-to-end anastomosis of the colon to rectum has been associated with fecal frequency and tenesmus in up to 70% of cases. The construction of a rectal J-pouch low-pressure reservoir has been reported to have a salutary effect upon these symptoms. Between March 1987 and January 1988 a pilot study was carried out in which six patients with primary or recurrent gynecologic malignancy who underwent low anterior resection of the colon requiring very low coloproctostomy (below 6 cm) had construction of a rectal J-pouch reservoir with a Strasbourg-Baker end-to-side coloproctostomy. No postoperative complications were noted in this small series of patients. No patient has had more than three stools per day since surgery. Antidiarrheal medication was not required. All patients denied tenesmus. It was concluded that the rectal J-pouch reservoir offered a surgical technique for avoiding tenesmus and fecal frequency in very low end-to-end anastomosis of colon to rectum.

Anastomosis, Surgical↗
PubMed1989

Rectal J-pouch reservoir to decrease the frequency of tenesmus and defecation in low coloproctostomy.

Low anterior resection of the colon with very low coloproctostomy is a procedure occasionally required in the surgical management of the patient with gynecologic malignancy. Very low end-to-end anastomosis of the colon to the rectum has been associated with fecal frequency and tenesmus in up to 70% of cases. The construction of a rectal J-pouch low-pressure reservoir has been reported to have a salutary effect on these symptoms. Between March 1987 and April 1988, a pilot study was carried out in which 11 patients with primary or recurrent gynecologic malignancy who underwent low anterior resection of the colon requiring very low coloproctostomy (below 6 cm) had construction of a rectal J-pouch reservoir with a Strasbourg-Baker end-to-side coloproctostomy. No postoperative complications were noted in this small series of patients. No patient has had more than three stools per day since surgery. Antidiarrheal medication was not required. All patients denied tenesmus. It was concluded that the rectal J-pouch reservoir offered a surgical technique for avoiding tenesmus and fecal frequency in very low end-to-end anastomosis of colon to rectum.

Adult↗
PubMed2006

Electro-acupuncture attenuates stress-induced defecation in rats with chronic visceral hypersensitivity via serotonergic pathway.

Acupuncture has long been used for patients with irritable bowel syndrome. However, it has remained unclear. The aim of this study was to testify the effect of electro-acupuncture(EA) on (1) visceral hypersensitivity induced by the mechanical colorectal irritation during postnatal development of rats, and (2) stress-induced colonic motility changes on rats with chronic visceral hypersensitivity. The abdominal withdrawal reflex (pain threshold and score) for visceral hypersensitivity and fecal pellet output for motor dysfunction were selected as two indexes for measurement. In addition, the effect of EA on 5-HT(4a) receptor and serotonin transporter (SERT) expression in the colon mucosa was analyzed semi-quantitatively through immunohistochemistry and 5-HT concentration in the colon tissue was observed through spectro-photo-fluorimeter detection, respectively. Our results showed that EA significantly elevated pain threshold, decreased the scores and also decreased fecal pellet output during water avoid stress. Furthermore, EA decreased 5-HT concentration in colon in rats with CVH and CVH rats with water avoidance stress, and increased the 5-HT(4a) and SERT expression in rats with CVH. Thus, it can be concluded that EA attenuates behavioral hyperalgesia and stress-induced colonic motor dysfunction in CVH rats via serotonergic pathway.

Animals↗