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PubMed2004

Evidence for differential modulation of conditioned aversion and fear-conditioned analgesia by CB1 receptors.

Fear-conditioned analgesia is an important survival response mediated by substrates controlling nociception and aversion. Cannabinoid(1) (CB(1)) receptors play an important role in nociception and aversion. However, their role in fear-conditioned analgesia has not been investigated. This study investigated the effects of systemic administration of the CB(1) receptor antagonist, SR141716A (1 mg/kg, i.p.), on fear-conditioned analgesia and conditioned aversion in rats. Twenty-four hours after receiving footshock, rats exhibited reduced formalin-evoked nociceptive behaviour, increased freezing and increased defecation when tested in the footshock apparatus, compared with non-footshocked formalin-injected rats. SR141716A attenuated fear-conditioned analgesia, freezing and defecation. Importantly, SR141716A had no effect on formalin-evoked nociceptive behaviour over an equivalent time period in rats not receiving footshock. SR141716A had no effect on contextually induced freezing during the first half of the test trial in rats receiving intra-plantar injection of saline. Administration of SR1417176A did, however, attenuate short-term extinction of contextually induced freezing and ultrasound emission in rats receiving intra-plantar saline, compared with vehicle-treated saline controls. These data suggest an important role for the CB(1) receptor in mediating fear-conditioned analgesia and provide evidence for differential modulation of conditioned aversive behaviour by CB(1) receptors during tonic, persistent pain.

Analgesia↗
PubMed2006

Rectal sensation, pelvic floor function and symptom severity in Hispanic population with irritable bowel syndrome with constipation.

OBJECTIVE: In patients with irritable bowel syndrome with constipation (IBS-C, Rome II) we determined if pelvic floor function correlates with rectal sensitivity and tone, and if the pelvic and rectal measurements correlate with symptoms. PATIENTS AND METHODS: Sensory thresholds and tone in fasting and postprandial states were evaluated with an electronic barostat in 34 patients and 10 normal controls. The pelvic floor was assessed by defaecography. RESULTS: Pain threshold to rectal distension was lower in IBS-C patients (P = 0.007). Postprandially, IBS-C patients showed lower values for sensation of gas, perception of urge, and pain threshold compared with controls. In IBS-C the anorectal angle widened less and showed less perineal mobility during defecation; the rectal tone in fasting IBS-C patients correlated with the angle at rest (P = 0.04) and with the perineal descent at rest (P = 0.01). The severity of abdominal discomfort or pain, and abdominal fullness correlated with the anorectal angle. The duration of symptoms and frequency of bowel movements correlated with perineal descent. Straining, mucus expulsion, and the feeling of incomplete evacuation correlated with rectal sensitivity variables. CONCLUSION: Patients with IBS-C have lowered sensory thresholds for noxious and non-noxious stimuli, increased visceral sensitivity after food, less perineal mobility during defecation, and symptoms that correlate with rectal sensitivity and pelvic floor parameters.

Adult↗
PubMed1989

Effects of acute and chronic administration of two antibiotics, aztreonam and gentamicin, alone or in combination, on "open-field test" in mice.

A study aimed at investigating the behavioural effects of aztreonam and gentamicin, given separately or in combination, was carried out in mice. Animals were randomly assigned to two test conditions: acute and chronic treatment. Those receiving acute treatment had a single IP injection 60 min before the test. Those receiving chronic treatment had IP injections once daily for 5 successive days prior to the test. Behavioural patterns (ambulation, rearing, grooming and defecation) were assessed using the "open-field" test. The results indicate that, both after single and multiple dosing, aztreonam (10, 40 and 80 mg/kg IP) and/or gentamicin (10 mg/kg IP) do produce changes in the behaviour of animals. A rate increasing effect for certain behaviours (rearing, grooming and defecation) and a reduction in other behaviours (ambulation) seems to occur.

Animals↗
PubMed1999

Gastrointestinal symptoms in long-distance runners, cyclists, and triathletes: prevalence, medication, and etiology.

OBJECTIVE: The aim of this study was to determine the prevalence of exercise-related gastrointestinal (GI) symptoms and the use of medication for these symptoms among long-distance runners, cyclists, and triathletes, and to determine the relationship of different variables to GI symptoms. METHODS: A mail questionnaire covering the preceding 12 months was sent to 606 well-trained endurance type athletes: 199 runners (114 men and 85 women), 197 cyclists (98 men and 99 women), and 210 triathletes (110 men and 100 women) and sent back by 93%, 88%, and 71% of these groups, respectively. Symptoms were evaluated with respect to the upper (nausea, vomiting, belching, heartburn, chest pain) or lower part of the GI tract (bloating, GI cramps, side ache, urge to defecate, defecation, diarrhea). For statistical analysis, Mann-Whitney U test, Fisher exact test, or Student t test were used. RESULTS: Runners experienced more lower (prevalence 71%) than upper (36%) GI symptoms during exercise. Cyclists experienced both upper (67%) and lower (64%) symptoms. Triathletes experienced during cycling both upper (52%) and lower (45%) symptoms, and during running more lower (79%) than upper (54%) symptoms. Bloating, diarrhea, and flatulence occurred more at rest than during exercise among all subjects. In general, exercise-related GI symptoms were significantly related to the occurrence of GI symptoms during nonexercise periods, age, gender, diet, and years of training. The prevalence of medication for exercise-related GI symptoms was 5%, 6%, and 3% for runners, cyclists, and triathletes, respectively. CONCLUSIONS: Long-distance running is mainly associated with lower GI symptoms, whereas cycling is associated with both upper and lower symptoms. Triathletes confirm this pattern during cycling and running. The prevalence of medication for exercise-related GI symptoms is lower in the Netherlands in comparison with other countries, in which a prevalence of 10-18% was reported. More research on the possible predisposition of athletes for GI symptoms during exercise is needed.

Adult↗
PubMed2002

Prospective evaluation of anorectal function after total mesorectal excision for rectal carcinoma with or without preoperative radiotherapy.

OBJECTIVE: Anorectal function is greatly disturbed after rectal surgery with or without radiotherapy (RT). To clarify the underlying mechanisms, we designed a prospective study to evaluate the effect of RT and surgery on anorectal function and clinical outcome of patients with a rectal carcinoma. METHODS: Thirty-four patients with a rectal carcinoma participated in this study. They filled out a symptom questionnaire and underwent anal manometry, anal and rectal mucosal electrosensitivity testing, and a rectal barostat, before surgery, 4 and 12 months postoperatively. Thirteen patients were lost to follow-up, 14 underwent surgery alone (total mesorectal excision [TME]), and seven also received RT (RT + TME). RESULTS: Functional outcome was disappointing in both groups, with at 4 months a significantly higher defecation frequency after RT + TME as compared with TME. Anal sphincter function and rectal sensitivity to pressure-controlled distention were not affected by either treatment. Rectal compliance, however, was significantly reduced after RT + TME at 4 and 1 2 months, resulting in lower rectal volumes at the thresholds for first sensation and desire to defecate. Rectal but not anal mucosal electrosensitivity was higher after TME + RT. CONCLUSIONS: Anorectal function after rectal surgery with or without RT is greatly hampered because of a decreased rectal compliance. After 12 months, partial improvement is shown, especially in the absence of RT.

Adult↗
PubMed2006

Pathophysiology and role of biofeedback therapy in solitary rectal ulcer syndrome.

BACKGROUND: Solitary rectal ulcer syndrome (SRUS) is a behavioral disorder whose pathophysiology is incompletely understood. Likewise, its treatment, particularly the role of biofeedback therapy (BT) is unclear. AIM: To evaluate anorectal function and morphology and to assess efficacy of BT. METHODS: Eleven patients (8f) with refractory SRUS underwent symptom assessments, anorectal manometry, defecography, balloon expulsion test, and sigmoidoscopy. Physiological tests were also performed in 15 (11f) healthy controls. Subsequently, SRUS patients underwent biofeedback treatment. Symptoms and manometry were reassessed. RESULTS: Nine (82%) patients exhibited dyssynergia ( p < 0.001). Rectal sensory thresholds were decreased (p < 0.04). After biofeedback, straining effort and stool frequency decreased ( p < 0.05), and bowel satisfaction score (VAS) improved ( p < 0.001). Digital maneuvers were discontinued by all five patients and bleeding stopped in 56%. The defecation index increased ( p < 0.05), dyssynergia normalized, and balloon expulsion time decreased ( p < 0.05). There was complete healing in 4 (36%), > or =50% healing in 2 (18%), and <50% healing in 4 (36%) patients. CONCLUSIONS: SRUS associated with excessive straining, digital disimpaction, rectal hypersensitivity, dyssynergic defecation, and prolonged evacuation. BT may improve symptoms and anorectal function and facilitate healing.

Adolescent↗
PubMed2002

Relationship between faecal character and intestinal transit time in normal dogs and diet-sensitive dogs.

The relationship between stool character and whole gut transit time (WGTT), which is the average time for the passage of material through the lumen of the alimentary tract from ingestion to defecation, was studied in eight control dogs and 12 dogs with non-specific dietary sensitivity. Dogs were fed four diets in a cross-over design, and faecal quality was assessed daily and WGTT determined using plastic pellets. Faecal quality was unaffected by diet in the control dogs. Dogs with dietary sensitivity produced looser faeces compared with the control dogs, and this was significant for two of the diets. There was no significant effect of diet on mean WGTT within or between groups. Minimum WGTT, which was the interval to the first appearance of markers in faeces, was shorter in sensitive dogs compared with controls, and this was significant for two of the four diets. There were significant, inverse relationships between minimum WGTT and both mean faeces score and percentage unacceptable defecations. These data suggest that rapid transit of certain dietary components may impact negatively on stool quality and contribute to loose faeces in dogs with non-specific dietary sensitivity.

Animals↗
PubMed2005

Calcium feedback mechanisms regulate oscillatory activity of a TRP-like Ca2+ conductance in C. elegans intestinal cells.

Inositol-1,4,5-trisphosphate (IP3)-dependent Ca2+ oscillations in Caenorhabditis elegans intestinal epithelial cells regulate the nematode defecation cycle. The role of plasma membrane ion channels in intestinal cell oscillatory Ca2+ signalling is unknown. We have shown previously that cultured intestinal cells express a Ca2+-selective conductance, I(ORCa), that is biophysically similar to TRPM7 currents. I(ORCa) activates slowly and stabilizes when cells are patch clamped with pipette solutions containing 10 mm BAPTA and free Ca2+ concentrations of approximately 17 nm. However, when BAPTA concentration is lowered to 1 mm, I(ORCa) oscillates. Oscillations in channel activity induced simultaneous oscillations in cytoplasmic Ca2+ levels. Removal of extracellular Ca2+ inhibited I(ORCa) oscillations, whereas readdition of Ca2+ to the bath caused a rapid and transient reactivation of the current. Experimental manoeuvres that elevated intracellular Ca2+ blocked current oscillations. Elevation of intracellular Ca2+ in the presence of 10 mm BAPTA to block I(ORCa) oscillations led to a dose-dependent increase in the rate of current activation. At intracellular Ca2+ concentrations of 250 nm, current activation was transient. Patch pipette solutions buffered with 1-4 mm of either BAPTA or EGTA gave rise to similar patterns of I(ORCa) oscillations. We conclude that changes in Ca2+ concentration close to the intracellular opening of the channel pore regulate channel activity. Low concentrations of Ca2+ activate the channel. As Ca2+ enters and accumulates near the pore mouth, channel activity is inhibited. Oscillating plasma membrane Ca2+ entry may play a role in generating intracellular Ca2+ oscillations that regulate the C. elegans defecation rhythm.

Animals↗
PubMed1963

BEHAVIOR OF ADULT RATS IS MODIFIED BY THE EXPERIENCES THEIR MOTHERS HAD AS INFANTS.

Some rat pups were handled for 20 days in infancy, while others were not. When the rats reached adulthood the females were bred. Some of the offspring were left with their natural mothers, others were fostered to mothers of the same background (handled/nonhandled) as that of their natural mothers, while still others were fostered to mothers with a different background from that of their natural mothers. The offspring were weaned and weighed at 21 days; at 50 days, activity and defecation scores were obtained in the open field. The weights at weaning and the defecation scores at 50 days were significantly influenced by the experience in infancy of the "postnatal" mother, whether she was the natural mother or a foster mother. The natural mother and the foster mother jointly affected the open-field activity of the offspring.

Animals↗
PubMed1996

Diagnostic dilemmas and results of treatment for chronic constipation.

Chronic functional constipation (CFC) may be difficult to recognise and information regarding its long term prognosis is scarce. The records of 244 children with CFC, aged 0-18 years, were analysed for symptoms at presentation and results of treatment, and long term outcome was evaluated by means of a telephone interview in 137 patients discharged for more than one year. The patients presented with a great variety of symptoms, only 22% having infrequent defecation of increased consistency, another 22% having an obviously normal defecation pattern. The mean duration of treatment was 13 months. At the time of discharge, 69% of the patients still used laxatives. At a median of four years after discharge, 66% of the children were free of symptoms and without medication, 39% having experienced a recurrence. It is concluded that CFC may be difficult to recognise and can be alleviated by an intensive laxative regimen. Recurrence of symptoms is common, but the long term prognosis is good in most patients.

Adolescent↗
PubMed1998

Randomised controlled trial of biofeedback training in persistent encopresis with anismus.

BACKGROUND: Paradoxical external anal sphincter contraction during attempted defecation (anismus) is thought to be an important contributor to chronic faecal retention and encopresis in children. Biofeedback training can be used to teach children to abolish this abnormal contraction. METHODS: A randomised controlled trial in medical treatment resistant and/or treatment dependent children with anismus using surface electromyographic (EMG) biofeedback training to determine whether such training produces sustained faecal continence. Up to four sessions of biofeedback training were conducted at weekly intervals for each patient. Anorectal manometry was performed before randomisation and six months later. Parents of patients completed the "child behaviour checklist" (CBCL) before randomisation and at follow up. RESULTS: Sixty eight children underwent anorectal manometry and EMG. Of these, 29 had anismus (ages 4-14 years) and were randomised to either EMG biofeedback training and conventional medical treatment (BFT) (n = 14) or to conventional medical treatment alone (n = 15). All but one child were able to learn relaxation of the external anal sphincter on attempted defecation. At six months' follow up, laxative free remission had been sustained in two of 14 patients in the BFT group and in two of 15 controls (95% confidence interval (CI) on difference, -24% to 26%). Remission or improvement occurred in four of 14 patients in the BFT group and six of 15 controls (95% CI on difference, -46% to 23%). Of subjects available for repeat anorectal manometry and EMG at six months, six of 13 in the BFT group still demonstrated anismus v 11 of 13 controls (95% CI on difference, -75% to -1%). Of the four patients in full remission at six months, only one (in the BFT group) did not exhibit anismus. Rectal hyposensitivity was not associated with remission or improvement in either of the groups. Mean CBCL total behaviour problem scores were not significantly different between the BFT and control groups, but there was a significant improvement in CBCL school scale scores in the BFT group, and this improvement was significantly greater than that seen in the control group. CONCLUSIONS: The result of this study, together with those reported in other controlled trials, argues against using biofeedback training in children with encopresis.

Adolescent↗
PubMed1994

Discriminant value of psychological distress, symptom profiles, and segmental colonic dysfunction in outpatients with severe idiopathic constipation.

Severe idiopathic constipation can be categorised based on physiological testing into subgroups including slow transit constipation and pelvic floor dysfunction. This study aimed to determine if colonic and psychological symptoms, or rectosigmoid transit times, could discriminate among these subgroups. Patients, categorised according to total colonic transit times and pelvic floor function testing, completed a self report questionnaire that recorded symptoms and psychological distress. Patients with normal transit constipation (n = 60) had significantly increased depression scores compared with those who had slow transit constipation (n = 70) or pelvic floor dysfunction (n = 30). The general severity index (GSI, a measure of overall psychological distress) negatively but weakly correlated with total colonic transit (r = -0.26, p < 0.01). A feeling of anal blockage was the only symptom that was associated with pelvic floor dysfunction (v normal transit constipation). Only a more regular defecation pattern, utilisation of different postures to defecate, and a feeling of incomplete evacuation were associated with slow v normal transit constipation. Psychological or colonic symptoms were not, however, significant discriminators in a multivariate analysis. Rectosigmoid transit times at 80% sensitivity had very poor specificity for discriminating pelvic floor dysfunction from other subgroups. It is concluded that clinical symptoms, psychological distress, and rectosigmoid transit times cannot be used to identify subgroups of patients with intractable constipation.

Adult↗
PubMed1995

Controlled randomised trial of visual biofeedback versus muscle training without a visual display for intractable constipation.

Training to contract the abdominal muscles effectively and to relax the pelvic floor during defecation straining helps some patients with severe constipation. Hitherto all such training has used a visible or audible signal of sphincter muscle activity as a biofeedback method to assist in relaxation. A randomised controlled trial comparing the outcome of muscular training without any biofeedback device with the same training supplemented by an electromyographic (EMG) record visible to the patient is reported. Significant symptomatic improvement was noted and electromyographic measurements confirmed a decrease in pelvic floor muscle activity during defecation straining after treatment in both groups. The outcome was similar in the two treatment groups. Muscular coordination training using personal instruction and encouragement without a visual display is thus a potentially successful treatment suitable for outpatient use by paramedical personnel.

Adult↗
PubMed2004

Dyschezia in dogs with discrete erosive anal disease and histological lesions suggestive of mucocutaneous lupus erythematosus.

Eight dogs suffered chronic defecation problems characterised by severe dyschezia, manifested by signs of fear and vocalisation on defecation. One or more depigmented, discrete erosions, easily bleeding on palpation, were found in the perineal region. Histopathological changes included interface dermatitis, apoptotic keratinocytes, focal hydropic degeneration of basal epidermal cells, focal thickening of the basement membrane zone and dermal lichenoid infiltrations with mononuclear and plasma cells. A diagnosis of cutaneous or discoid lupus erythematosus was made on the basis of these clinical, physical and specific histopathological changes. The dogs were treated systemically with immunomodulating drugs and good results were obtained.

Animals↗
PubMed1999

Gastrointestinal motor and myoelectric correlates of motion sickness.

The objectives of this study were to characterize the digestive tract motor and myoelectric responses associated with motion sickness. Twenty-two cats (1.5-3.0 kg) were chronically implanted with force transducers and electrodes on the stomach and small intestine. Motion sickness was activated by vertical oscillation (VO) at +/-0.5 g and identified as salivation, licking, or vomiting. Vomiting was initiated chemically by UK-14304 (2.5-15 microg/kg iv) or CuSO4 (10-50 mg ig). We found that VO caused vomiting (45% of trials), a decrease in gastrointestinal (GI) motility (69% of trials), salivation or licking (59% of trials), bradygastria (39% of trials), retrograde giant contraction (RGC, 43% of trials), giant migrating contraction (GMC, 5% of trials), and defecation (18% of trials). The decrease in GI motility occurred with (62% of trials) or without (69% of trials) vomiting. Motion sickness was accompanied by bradygastria (52% of trials) and decreased GI motility (70% of trials). Similar events occurred after CuSO4 and UK-14304, but the incidences of responses after CuSO4 were less frequent, except for vomiting, RGC, and GMC. UK-14304 never caused GMCs or defecation. The magnitude and velocity of the RGC were the same during all emetic stimuli, and RGCs never occurred without subsequent vomiting. Supradiaphragmatic vagotomy (n = 1) or atropine (n = 2, 10 or 50 microg/kg iv) blocked the RGC, but not vomiting, due to VO. We concluded that 1) oculovestibular stimulation causes digestive tract responses similar to other types of emetic stimuli, 2) decreased GI motility and bradygastria may be physiological correlates of the motion sickness, and 3) motion sickness may not be dependent on any specific GI motor or myoelectric response.

Animals↗
PubMed2003

Quality of life assessment after pancreatic enzyme replacement therapy in chronic pancreatitis.

GOALS: To evaluate the quality of life (QoL) of patients with chronic pancreatitis before and after pancreatic enzyme replacement therapy in a prospective, multicentre, follow-up study. STUDY: Two groups of patients were evaluated. Group 1 consisted of 31 patients with newly diagnosed chronic pancreatitis who had never been treated with pancreatic enzyme preparations. Group 2 consisted of 39 patients whose disease was diagnosed on average 3.4 years before the start of the study. The latter group of patients had undergone pancreatic enzyme replacement therapy, but during follow-up this treatment proved to be insufficient. The dose of pancreatic enzyme replacement therapy was tailored in accordance with the degree of pancreatic exocrine insufficiency measured by means of exocrine pancreatic function tests. A modified European Organizaton for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) was used to assess QoL. RESULTS: The social functioning and financial strain were significantly better, while the levels of hope and confidence were significantly reduced in group 1 compared with group 2. A significant gain in body weight and a significantly reduced defecation rate were found in both groups one month after the beginning of the pancreatic enzyme replacement therapy when compared with the pretreatment values. The prevalence of general and disease-specific symptoms and the intensity of pain were reduced in both groups after one month of enzyme substitution therapy. The working ability, the financial strain and the overall QoL scores were improved significantly in both groups, while the cognitive functioning score was found to be significantly improved during the follow-up only in group 1. The overall increase in the QoL score correlated significantly with the increase in body weight and the decrease in defecation number in both groups. CONCLUSIONS: Pancreatic enzyme replacement therapy in patients with chronic pancreatitis not only reduced the extent of steatorrhea and pain, but also significantly improved a variety of other symptoms and the patient's QoL. Individually tailored enzyme replacement therapy improved the QoL not only in the untreated chronic pancreatitis patients, but also in the inadequately treated group. This study demonstrated that the EORTC QLQ-C30 questionnaire, with the addition of two further questions about steatorrhea, is a useful tool for the evaluation of QoL in patients with chronic pancreatitis.

Abdominal Pain↗
PubMed2005

[Functional constipation: prospective study and treatment response].

OBJECTIVE: To assess the prevalence of functional constipation (FC) with and without encopresis, the factors involved in its onset, and treatment response. PATIENTS AND METHODS: A prospective study of 62 children was performed using a standard questionnaire (onset-age, regular toilet use, encopresis, complications, dietary habits and environmental and psychological factors) and physical and anthropometric assessment. FC was defined as a stool frequency of less than 3 bowel movements/week, with passage of large or scybalous stools, with or without 2 or more soiling episodes per week, without underlying disease. Treatment included demystification, behavioral modification and drugs (mineral oil and senna). Each child was periodically re-evaluated, and treatment was considered successful when the defecation rate was 3 or more bowel movements/week, discomfort was absent, and fecal soiling frequency was 2 or fewer episodes/ month. RESULTS AND CONCLUSIONS: FC accounted for 13 % of all first consultations (60 % boys, 40 % girls; mean age at diagnosis 6.1 years). The most frequent manifestations were painful defecation (60 %), rectorrhagia (42 %), obstructive episodes (34 %) and anal fissure or hemorrhoids (17 %); 19 patients (31 %) had encopresis. Nutritional assessment revealed that 84 % of the patients was well nourished and 16 % was overweight. Fiber intake was deficient in more than 60 %. Sixteen (26 %) patients underwent successful relief of impaction with senna (20-30 mg/dose) combined with mineral oil. Maintenance treatment included mineral oil (15-30 ml/day) and senna at the minimum effective dose (5-15 mg/day). Satisfactory results were achieved 1 month later in 32 % of the children, 3-6 months later in 71 %, and 6-12 months later in 85 %; successful response was closely related to regular toilet habits, dietary modification and a shift in the family's attitude.

Adolescent↗
PubMed2000

Effect of sigmoid colon distension on the rectosigmoid junction. Description of the rectosigmoid junction tightening reflex and its clinical implications.

PURPOSE: The sigmoid colon (SC) is the site of stool storage. The stools accumulate in the SC until, at a certain volume, the mechanoreceptors in the SC wall are stimulated, evoking the sigmoidorectal junction inhibitory reflex with a resulting SC contraction, rectosigmoid junction (RSJ) relaxation and passage of the stools to the rectum. However, the RSJ status during stool accumulation in the SC has been scarcely addressed in the literature. The current study investigated this point. METHODS: A balloon-ended tube was introduced into the SC of 21 healthy volunteers [mean age (+/- SD) 36.8 +/- 10.3 years; 15 men and 6 women]. The pressures in the SC and RSJ were measured by means of a perfused tube, at rest and during balloon inflation with carbon dioxide at two rates: slow (3 ml/min) and rapid (150 ml/min). The tests were repeated after individual anesthetization of the SC and RSJ. RESULTS: During slow SC distension up to 80 ml included, the RSJ pressure progressively increased while the SC exhibited no pressure response (p > 0.05). At a distending volume of 100 ml, the pressure in the SC rose (p < 0. 01) and declined in the RSJ (p < 0.05), and the balloon was dispelled to the rectum. Rapid SC distension up to 40 ml included, effected no SC pressure response (p > 0.05) while the RSJ showed progressive pressure elevation. At 60 ml distension, the SC recorded a pressure rise (p < 0.001) and the RSJ a pressure decrease (p < 0. 05); the balloon was dispelled to the rectum. The pressure in the RSJ did not respond to distension of the anesthetized SC. CONCLUSION: The study has shown that, during accumulation of stools in the SC, leakage to the rectum seems to be prevented by a reflex action which we call 'rectosigmoid junction tightening reflex'. This reflex probably acts to control both storage and emptying of the SC contents. Reflex dysfunction might lead to defecation disorders. We suggest that the RSJ tightening reflex be included as an investigative tool in the diagnosis of defecation disorders.

Adult↗