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PubMedDate not supplied

Sensorimotor evaluation of ano-rectal complex in diabetes mellitus.

To evaluate the status of ano-rectal complex in diabetic patients, 20 patients with no fecal incontinence and/or local ano-rectal disorders and 18 normal subjects underwent to: 1) ano-rectal manometry; 2) defecography; and 3) rectal sensation tests. In all subjects, the five classic cardiovascular reflexes tests were performed to detect autonomic neuropathy. No significant difference between diabetic patients and controls was found in length, maximum resting pressure and strength of phasic external anal sphincter or anal canal at ano-rectal manometry; similarly, no significant difference between diabetic and normal subjects was found by the same technique in threshold and amplitude of ano-rectal inhibitory reflex. Ano-rectal angle of diabetic patients was not significantly different from normals both at resting and during straining at defecographic study. By rectal sensation testing, it was possible to demonstrate a significant difference between diabetic and normal subjects in perception of rectal distension (87.5 +/- 27.5 vs 39.2 +/- 6.5 ml, p less than 0.05; mean +/- SEM) and of stimulus of defecation (147.0 +/- 56.3 vs 52.9 +/- 18.5 ml, p less than 0.001) but not in perception of maximum tolerable volume (343.5 +/- 69.9 vs 322.0 +/- 48.5 ml, p = NS). No relationship was found between these results and the score of autonomic neuropathy and/or duration of diabetic disease. These data suggest that an early involvement of only sensory parasympathetic fibers of ano-rectal complex occurs in diabetic patients without gastrointestinal symptoms.

Adolescent↗
PubMed1991

[Modified super anterior resection of rectal carcinoma with transpubic approach].

To ensure good exposure of operative field and to reduce the complications of low anterior resection of rectal carcinoma with transpubic approach, we modified Ackerman's method and operated on 18 patients with middle and lower rectal carcinoma at the level of 4-8 cm above the anus. 1cm width of the inferior part of the pubic symphysis was preserved. Results were compared with 19 patients operated on in the original way. Dissection of the arcuate ligament, penis suspensory ligament and penis nerve under the lower pubic margin was avoided, so that cyanosis of the penis, perineum and occurrence of sexual dysfunction were reduced, and the period of postoperative pain was shortened. 89% of patients operated in this way enjoyed good defecating function. We suggest that this procedure is indicated in all patients with rectal carcinoma located 4-7 cm above the anus with the exception of mucinous carcinoma.

Defecation↗
PubMed1991

[Practical indications for anorectal manometry].

Anorectal manometry has taken on an important role in the investigation of functional anorectal disorders. This investigation studies the two factors, the resistive system and the capacitive system, involved in anorectal function, continence and defecation. Practical indications can be grouped into three categories concerning different aspects of physiopathological, diagnostic and therapeutic interest. Manometry is essential in the investigation of disorders of pelvic static function, is useful in colorectal surgery and of interest in a wide range of proctological diseases.

Anus Diseases↗
PubMed1991

Changes in open-field behavior of rats following spinal nerve root sectioning.

The open-field behavior of of 30 laboratory albino rats was measured after selective unilateral sectioning of either the L2, L3, L4 or L5 spinal nerve root using a novel abdominal entry. Although treated subjects displayed observable motor dysfunction of the operated limb, no differences were found in open-field ambulation, rearing, defecation or urination based either on the level of the sectioned nerve root or on the day the behavior was measured, suggesting that there was an effect of the treatment not measurable by standard statistical procedures, quite possibly due to the small sample size.

Animals↗
PubMedDate not supplied

[Digital videoradiography applied to the study of the recto-anal region during defecography].

The authors have employed a real-time fluoroscopic computerized equipment during defecography. Digitalized images were acquired at a rate of three frames/s and then processed and became immediately available. Digital defecography was employed in 67 patients with various anorectal diseases--i.e., rectocele, descending perineum, rectal prolapse, non-relaxing puborectalis syndrome and fecal incontinence. We found time-interval difference (TID) technique especially useful for it allowed different functional phases of defecation to be depicted on a single subtracted image and an evaluation of the movements of anorectal region. The high contrast resolution of the computerized equipment demonstrated even minimal contrast medium leaks in fecal incontinence. The examination is easy and rapid to perform with a low radiation dose to the patients.

Defecation↗
PubMed1990

Observations with Imodium in diarrhoeal women.

The antidiarrhoeal effect of loperamide (Imodium) has been examined in 87 hospitalized gynaecological patients suffering from diarrhoea of different origins. The characteristic parameters and the carbon passage time were observed. According to observations Imodium has a rapid action, decreases the number of daily defecations, normalizes the consistency of stool, and controls the other symptoms accompanying diarrhoea. It increases passage time. The drug has no notable side effect and is of high value in controlling or preventing diarrhoeas caused by stress situations.

Adolescent↗
PubMed1990

Chronic idiopathic constipation with outlet obstruction.

Defecatory difficulties may be a source of great distress to patients. Normal defecation requires the coordination of abdominal and pelvic muscles. Throughout the last decade, many studies have demonstrated various and often mixed abnormalities of these mechanisms. Pathophysiological studies are able to determine, in a specific patient, the most probable causes of the obstructive symptom. Progress in the management of such disorders can only be achieved by understanding their pathophysiology.

Aged↗
PubMedDate not supplied

Defecography: techniques for improved image quality.

Defecography is a radiographic study that demonstrates the physiological process involved when the rectum evacuates. Fluoroscopy, video recording and spot films are used to record the sequence of events that occur during defecation. Proper radiographic techniques and procedures must be used to demonstrate pathological conditions such as rectoceles, rectal intussusception and prolapse of the rectum.

Defecation↗
PubMed1985

Dating the time interval from meconium passage to birth.

The gross and microscopic effects of exposing placenta and umbilical cord to meconium were studied in vitro. Gross staining begins with one hour and is a surface phenomenon proportional to length of exposure and meconium concentration. Pigment penetration into the membranes with subsequent uptake by macrophages is dependent primarily on exposure length. Eight of 11 placentas exposed to various meconium solutions were found to have meconium pigment-laden macrophages in the amnion after one hour. These were seen in the chorion somewhat later. Although only three of 11 placentas showed chorionic pigmented macrophages at one hour, 12 of 12 exhibited this finding after three hours. Amniotic epithelial degeneration also showed a time correlation. These findings, especially the microscopic changes described, permit more accurate determination of the defecation-to-birth interval.

Defecation↗
PubMed1989

[Possibility of radiology in the study of defection disorders].

Chronic constipation and defecation disorders are a very common disease, but the diagnosis is often unsatisfactory and therefore therapy is mostly inadequate. The purpose of this paper is to demonstrate the contribution of radiological procedures and mainly of the defecography, in improving and determining the diagnosis itself. Many normal and pathological cases are reviewed, described and demonstrated by radiological patterns. Finally, a correct protocol of different procedures, radiological and not, for morphological and functional study of large bowel and pelvis floor is stressed.

Barium Sulfate↗
PubMed1989

[Analysis of sexual differences in emotional reactions in rats].

The effect of sex differences on the emotional reactivity in the rat (Rattus norvegicus) has been analyzed by means of the open field test and the acquisition of a conditioned emotional response (C.E.R.), according to Estes and Skinner technique. The combined use of C.E.R. and defecation rate techniques shows that males present a higher emotional reactivity than females. Furthermore estrous cycle affected female ambulation rates in open field.

Animals↗
PubMedDate not supplied

[Spontaneous and orienting-exploratory motor activity in rats with hereditary arterial hypertension].

In rats of spontaneously hypertensive line (SHR) in comparison with normotensive animals of WKY line an increased activity was revealed in new surroundings in conditions of open illuminated space, and reduced activity in limited darkened space with weakened extinction of activity. Male SHR rats had a higher daily motor activity and SHR females--a lower level of defecation. The revealed behavioural changes testify to an enhancement of investigatory motivation and weakening of "fear" in SHR rats as well as to increased excitatory and decreased inhibitory processes in these animals. Behavioural characteristics of SHR rats reflect an increased reactivity of their nervous system which may be connected with the mechanisms of the increase of arterial pressure.

Animals↗
PubMed1988

[A cause of terminal constipation: hypertonia of the striated pelvic muscle. Value of complementary studies].

The aim of this study was to define an other cause of idiopathic constipation with a mathematic automatic classification Fifty patients were studied by colonic transit time, anorectal manometry and defecography. Three classical causes were found: 12 patients had hypertonic upper anal pressure; 8 patients had abnormal rectonanal inhibitory reflex and 12 patients had anatomic conditions reducing stool frequencies Automatic mathematic classification coming from optimised bowls technic has led to the characterization of a new cause. Eight young women (mean age 33 years) with hypertonic striated pelvic muscles on straining were identified. Three items were significantly different: defect of sphincteric relaxation without high sphincteric pressure; closure or non opening anorectal angle, hypertonic levator ani on straining. There was a significant high frequency (p less than 0.05) of urinary disorders in this new group. All abnormalities occurred during defecation. This group can be studied with other methods: balloon expulsion, anal electromyography. Clinical identity with urinary pathology may be explained by common neurologic disorders of pelvic striated muscle innervation.

Adult↗
PubMed1988

[Behavioral and metabolic features of spontaneously hypertensive rats].

12-week old spontaneously hypertensive (SHR) rats in comparison with normotensive Wistar-Kyoto (WKY) rats had an enhanced behavioural activity associated with exploratory motivation and a lower one associated with the fear motivation, their daily activity and the activity associated with alternating illumination were also higher whereas their defecation was lower. No difference in oxygen metabolism was found at 12 weeks of age. 20-week SHR rats had a higher common oxygen consumption and lower pO2 and blood circulation velocity in the sensomotor area of the brain cortex.

Animals↗
PubMed1986

[Colonic inertia and rectal obstruction (Arbuthnot Lane disease)].

Colonic inertia and outlet obstruction are a major problem of constipation affecting almost solely women and are characterised by an extreme slowness of colonic transit time (less than 80 percent of the markers eliminated in five days) and by a lack of relaxation and a contraction of pelvic muscles, mainly of the pubo-rectalis, during defecation. This syndrome is associated with a high frequency of gynecological diseases (first described in 1908 by Arbuthnot Lane), galactorrhea, urological abnormalities, abnormal manometric oesophageal recordings, Raynaud's phenomenon, idiopathic oedema, orthostatic hypotension and neurological symptoms. A distinctive abnormality of the colonic myenteric plexus has been described. Medical treatment of the affection is without effect, with the exception, perhaps, of the prescription of naloxone. In the absence of other therapeutic means, subtotal colectomy with ileo-rectal and coeco-rectal anastomosis may give relative improvement.

Colectomy↗
PubMed1987

Comparative laxation of psyllium with and without senna in an ambulatory constipated population.

Our short-term study used objective and subjective criteria to evaluate the ability of two laxative preparations to relieve constipation. Forty-two adults who were constipated, i.e., had less than or equal to 3 bowel movements during 1 wk of a single-blind placebo treatment, were randomized to receive psyllium (7.2 g/day) or psyllium plus senna (6.5 + 1.5 g/day). Both laxatives increased defecation frequency and wet and dry stool weights although the added effect of the senna was clearly evident. Only the psyllium with senna increased stool moisture. Two distinct responses to the psyllium plus senna were evident; the subpopulation of high responders (n = 7) was responsible for most of the increase in stool frequency and dry weight in this group, and laxation in the subpopulation of normal responders (n = 12) was similar to that observed in those receiving psyllium alone. Both laxatives provided a similarly high degree of subjective relief and improvement in stool consistency. When constipation was assessed objectively by stool frequency and weight, laxation was attained by 63% of the psyllium plus senna group and 48% of the psyllium group.

Adult↗
PubMedDate not supplied

[Value of rectal sensitivity test in chronic childhood constipation].

The rectal sensitivity test evaluates the distension volume for which the initial transient sensation occurs on defecation (conscious rectal sensitivity threshold). The conscious rectal sensitivity threshold (S.S.R.C.) was performed on 10 normal controlled subjects and 103 children with chronic constipation, functional megarectum and normal rectoanal inhibitory reflex. Children were between 5 and 14 years old. S.S.R.C. was increased in children with chronic constipation. Encopresis was proportionally increased with relation to S.S.R.C. increase. A therapeutical protocol was applied in all patients. Fifteen patients are still being treated: 87 obtained a normal function within 8 to 23 months of treatment; in one case the treatment was unsuccessful. The period of treatment was proportional to S.S.R.C. increase. Physiopathological background of a correct management is discussed.

Adolescent↗