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. 1989 Apr;30(4):496–502. doi: 10.1136/gut.30.4.496

Rectal reservoir and sensory function studied by graded isobaric distension in normal man.

S Akervall 1, S Fasth 1, S Nordgren 1, T Oresland 1, L Hultén 1
PMCID: PMC1434044  PMID: 2714682

Abstract

The rectal expansion and concomitant sensory function on graded, isobaric, rectal distension within the interval 5-60 cm H2O was investigated in 36 healthy young volunteers. Anal pressure and electromyography (EMG) from the external anal sphincter were simultaneously recorded. Rectal distension caused an initial rapid expansion followed by transient, often repeated, reflex rectal contractions and a slow gradual increase of rectal volume. The maximal volume displaced by the first reflex rectal contraction was 18 (13) ml, which was less than 10% of the volume at 60 s. The pressure threshold for appreciation of rectal filling was 12 cm H2O (95% CL 5-15 cm H2O) and coincided with the threshold for rectoanal inhibition. Urge to defecate was experienced at 28 cm H2O (15-50 cm H2O) distension pressure, which was close to the threshold for maximal rectal contraction, also coinciding with the appearance of the external anal sphincter reflex. The interindividual variation of rectal volume on distension with defined pressures varied widely, indicating a considerable variation of rectal compliance in normal man. No correlation was found between rectal volume and sex or anthropometric variables. The relative variations in pressure thresholds for eliciting rectal sensation and rectoanal reflexes were less than the corresponding threshold volumes. It was concluded that the dynamic rectal response to distension reflects a well graded reflex adjustment ideal for a reservoir.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akervall S., Fasth S., Nordgren S., Oresland T., Hultén L. Manovolumetry: a new method for investigation of anorectal function. Gut. 1988 May;29(5):614–623. doi: 10.1136/gut.29.5.614. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Allan A., Ambrose N. S., Silverman S., Keighley M. R. Physiological study of pruritus ani. Br J Surg. 1987 Jul;74(7):576–579. doi: 10.1002/bjs.1800740710. [DOI] [PubMed] [Google Scholar]
  3. Arhan P., Faverdin C., Persoz B., Devroede G., Dubois F., Dornic C., Pellerin D. Relationship between viscoelastic properties of the rectum and anal pressure in man. J Appl Physiol. 1976 Nov;41(5 Pt 1):677–682. doi: 10.1152/jappl.1976.41.5.677. [DOI] [PubMed] [Google Scholar]
  4. Baldi F., Ferrarini F., Corinaldesi R., Balestra R., Cassan M., Fenati G. P., Barbara L. Function of the internal anal sphincter and rectal sensitivity in idiopathic constipation. Digestion. 1982;24(1):14–22. doi: 10.1159/000198769. [DOI] [PubMed] [Google Scholar]
  5. CALLAGHAN R. P., NIXON H. H. MEGARECTUM: PHYSIOLOGICAL OBSERVATIONS. Arch Dis Child. 1964 Apr;39:153–157. doi: 10.1136/adc.39.204.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. DUTHIE H. L., GAIRNS F. W. Sensory nerve-endings and sensation in the anal region of man. Br J Surg. 1960 May;47:585–595. doi: 10.1002/bjs.18004720602. [DOI] [PubMed] [Google Scholar]
  7. Farthing M. J., Lennard-jones J. E. Sensibility of the rectum to distension and the anorectal distension reflex in ulcerative colitis. Gut. 1978 Jan;19(1):64–69. doi: 10.1136/gut.19.1.64. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fasth S., Hultén L., Nordgren S. Evidence for a dual pelvic nerve influence on large bowel motility in the cat. J Physiol. 1980 Jan;298:159–169. doi: 10.1113/jphysiol.1980.sp013073. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. GOLIGHER J. C., HUGHES E. S. R. Sensibility of the rectum and colon. Its rôle in the mechanism of anal continence. Lancet. 1951 Mar 10;1(6654):543–547. doi: 10.1016/s0140-6736(51)92242-8. [DOI] [PubMed] [Google Scholar]
  10. Lane R. H., Parks A. G. Function of the anal sphincters following colo-anal anastomosis. Br J Surg. 1977 Aug;64(8):596–599. doi: 10.1002/bjs.1800640820. [DOI] [PubMed] [Google Scholar]
  11. Lawson J. O., Nixon H. H. Anal canal pressures in the diagnosis of Hirschsprung's disease. J Pediatr Surg. 1967 Dec;2(6):544–552. doi: 10.1016/s0022-3468(67)80011-3. [DOI] [PubMed] [Google Scholar]
  12. Loening-Baucke V., Anuras S. Effects of age and sex on anorectal manometry. Am J Gastroenterol. 1985 Jan;80(1):50–53. [PubMed] [Google Scholar]
  13. Meunier P., Mollard P., Marechal J. M. Physiopathology of megarectum: the association of megarectum with encopresis. Gut. 1976 Mar;17(3):224–227. doi: 10.1136/gut.17.3.224. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. O'Connell P. R., Pemberton J. H., Brown M. L., Kelly K. A. Determinants of stool frequency after ileal pouch-anal anastomosis. Am J Surg. 1987 Feb;153(2):157–164. doi: 10.1016/0002-9610(87)90807-5. [DOI] [PubMed] [Google Scholar]
  15. PORTER N. H. Megacolon: a physiological study. Proc R Soc Med. 1961 Dec;54:1043–1047. [PubMed] [Google Scholar]
  16. Read N. W., Timms J. M., Barfield L. J., Donnelly T. C., Bannister J. J. Impairment of defecation in young women with severe constipation. Gastroenterology. 1986 Jan;90(1):53–60. doi: 10.1016/0016-5085(86)90074-0. [DOI] [PubMed] [Google Scholar]
  17. Riis P. Therapeutic influence on the prognosis of ulcerative colitis. Scand J Gastroenterol. 1974;9(1):1–2. [PubMed] [Google Scholar]
  18. Roe A. M., Bartolo D. C., Mortensen N. J. Diagnosis and surgical management of intractable constipation. Br J Surg. 1986 Oct;73(10):854–861. doi: 10.1002/bjs.1800731031. [DOI] [PubMed] [Google Scholar]
  19. Scharli A. F., Kiesewetter W. B. Defecation and continence: some new concepts. Dis Colon Rectum. 1970 Mar-Apr;13(2):81–107. doi: 10.1007/BF02617635. [DOI] [PubMed] [Google Scholar]
  20. Sundin T., Carlsson C. A. Reconstruction of severed dorsal roots innervating the urinary bladder. An experimental study in cats. I. Studies on the normal afferent pathways in the pelvic and pudendal nerves. Scand J Urol Nephrol. 1972;6(2):176–184. doi: 10.3109/00365597209133634. [DOI] [PubMed] [Google Scholar]
  21. Suzuki H., Matsumoto K., Amano S., Fujioka M., Honzumi M. Anorectal pressure and rectal compliance after low anterior resection. Br J Surg. 1980 Sep;67(9):655–657. doi: 10.1002/bjs.1800670917. [DOI] [PubMed] [Google Scholar]
  22. WALLS E. W. Observations on the microscopic anatomy of the human anal canal. Br J Surg. 1958 Mar 18;45(193):504–512. doi: 10.1002/bjs.18004519317. [DOI] [PubMed] [Google Scholar]
  23. Williams N. S., Price R., Johnston D. The long term effect of sphincter preserving operations for rectal carcinoma on function of the anal sphincter in man. Br J Surg. 1980 Mar;67(3):203–208. doi: 10.1002/bjs.1800670313. [DOI] [PubMed] [Google Scholar]
  24. Womack N. R., Morrison J. F., Williams N. S. The role of pelvic floor denervation in the aetiology of idiopathic faecal incontinence. Br J Surg. 1986 May;73(5):404–407. doi: 10.1002/bjs.1800730531. [DOI] [PubMed] [Google Scholar]

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