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Anorectal physiology

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https://www.readbyqxmd.com/read/27910245/anorectal-manometry-should-it-be-performed-in-a-seated-position
#1
G-J Wu, F Xu, L Lin, P J Pasricha, J D Z Chen
BACKGROUND: Anorectal manometry (ARM) is typically preformed in a lateral position. This non-physiological testing position has produced an unexpected negative rectoanal pressure gradient (RAPG, i.e. difference between rectal and anal pressure) with normal defecation. This study was designed (i) to study differences in ARM parameters between water-perfused and solid-state sensors and between lateral and seated positions and (ii) to investigate the roles of ARM parameters in predicting balloon expulsion...
December 1, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27891696/gender-differences-in-chronic-constipation-on-anorectal-motility
#2
M Zakari, J Nee, W Hirsch, B Kuo, A Lembo, K Staller
BACKGROUND: The epidemiology of chronic constipation (CC) skews toward female predominance, yet men make up an important component of those suffering from CC. We sought to determine whether there are sex-specific differences in symptoms and physiologic parameters on anorectal manometry (ARM). METHODS: We performed a case-control analysis of sequential men and age-matched women (2:1 ratio) presenting for ARM as part of the evaluation of CC. We collected physiologic parameters derived from 3D high-resolution ARM in addition to the ROME III constipation module and the Pelvic Floor Distress Inventory 20 (PFDI-20) questionnaires...
November 27, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27881404/novel-insights-into-fecal-incontinence-in-men
#3
Yoav Mazor, Michael Jones, Alison Andrews, John E Kellow, Allison Malcolm
Fecal incontinence (FI) in men is common yet data on gender differences in clinical features, physiology and treatment is scarce. Our aim was to provide insights into FI in males compared to females. Prospectively collected data from 73 men and 596 women with FI in a tertiary referral centre was analysed. Anorectal physiology, clinical characteristics and outcome of instrumented biofeedback (BF) was recorded. 31 men with FI proceeded to BF and were matched with 62 age-matched women with FI who underwent BF...
November 23, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/27847787/anismus-physiology-radiology-is-it-time-for-some-pragmatism-a-comparative-study-of-radiological-and-anorectal-physiology-findings-in-patients-with-anismus
#4
Umberto Pisano, Lesley Irvine, Justina Szczachor, Ahsin Jawad, Andrew MacLeod, Michael Lim
PURPOSE: Anismus is a functional disorder featuring obstructive symptoms and paradoxical contractions of the pelvic floor. This study aims to establish diagnosis agreement between physiology and radiology, associate anismus with morphological outlet obstruction, and explore the role of sphincteric pressure and rectal volumes in the radiological diagnosis of anismus. METHODS: Consecutive patients were evaluated by using magnetic resonance imaging proctography/fluoroscopic defecography and anorectal physiology...
October 2016: Annals of Coloproctology
https://www.readbyqxmd.com/read/27824643/clinical-psychological-and-physiological-correlates-of-patients-who-defecate-after-meal
#5
Michel Bouchoucha, Ghislain Devroede, Florence Mary, Cyriaque Bon, Gheorges Airinei, Bakhtiar Bejou, Robert Benamouzig
BACKGROUND AND AIMS: Food is the most important synchronizer of gastrointestinal motility and secretion. Many patients with functional bowel or anorectal disorders complain of fecal urge and stool output after eating. PATIENTS AND METHODS: In this prospective observational study, 408 consecutive outpatients with functional bowel and/or anorectal disorders (74% female, 50.2±15.6 years, 24.8±5.0 kg/m²) filled Rome III questionnaires. Depression and anxiety scores, a physiological evaluation (total and segmental colonic transit time, colonic transit response to eating using a standard 1000 kcal test meal, and anorectal manometry), were measured...
November 7, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27738888/visceral-and-subcutaneous-adipose-tissue-express-and-secrete-functional-alpha2hsglycoprotein-fetuin-a-especially-in-obesity
#6
Diego Pérez-Sotelo, Arturo Roca-Rivada, María Larrosa-García, Cecilia Castelao, Iván Baamonde, Javier Baltar, Ana Belen Crujeiras, Luisa María Seoane, Felipe F Casanueva, María Pardo
The secretion of the hepatokine alpha-2-Heremans-Schmid glycoprotein/Fetuin A, implicated in pathological processes including systemic insulin resistance, by adipose tissue has been recently described. Thus, we have recently identified its presence in white adipose tissue secretomes by mass spectrometry. However, the secretion pattern and function of adipose-derived alpha-2-Heremans-Schmid glycoprotein are poorly understood. The aim of this study is to evaluate the expression and secretion of total and active phosphorylated alpha-2-Heremans-Schmid glycoprotein by adipose tissue from visceral and subcutaneous localizations in animals at different physiological and nutritional status including anorexia and obesity...
October 14, 2016: Endocrine
https://www.readbyqxmd.com/read/27686130/efficacy-of-anorectal-biofeedback-in-scleroderma-patients-with-fecal-incontinence-a-case-control-study
#7
Josephine Collins, Yoav Mazor, Michael Jones, John Kellow, Allison Malcolm
OBJECTIVE: To determine whether anorectal biofeedback therapy can improve the symptoms of fecal incontinence (FI) in patients with scleroderma when compared to patients with functional FI, and also whether there is any effect on anorectal physiology or quality of life (QOL). FI in patients with scleroderma is highly prevalent and is associated with significant loss of QOL. Biofeedback has been proven to be an effective treatment for functional FI, but there are no data to support its use in scleroderma...
December 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27672293/transanal-surgery-for-obstructed-defecation-syndrome-literature-review-and-a-single-center-experience
#8
REVIEW
Wei-Cheng Liu, Song-Lin Wan, S M Yaseen, Xiang-Hai Ren, Cui-Ping Tian, Zhao Ding, Ken-Yan Zheng, Yun-Hua Wu, Cong-Qing Jiang, Qun Qian
Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of life of patients from both societal and psychological aspects. The underlying anatomical and pathophysiological changes of ODS are complex. However, intra-rectal intussusception and rectocele are frequently found in patients with ODS and both are thought to play an important role in the pathogenesis of ODS. With the development of evaluation methods in anorectal physiology laboratories and radiology studies, a great variety of new operative procedures, especially transanal procedures, have been invented to treat ODS...
September 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27651788/influence-of-rectal-decompression-on-abdominal-symptoms-and-anorectal-physiology-following-colonoscopy-in-healthy-adults
#9
Chih-Hsun Yi, Tso-Tsai Liu, Wei-Yi Lei, Jui-Sheng Hung, Chien-Lin Chen
Background. Postcolonoscopy abdominal discomfort and bloating are common. The aim of this study was to evaluate whether rectal decompression improved distension-induced abdominal symptoms and influenced anorectal physiology. Methods. In 15 healthy subjects, rectal distension was achieved by direct air inflation into the rectum by colonoscopy. Placement of rectal and sham tube was then performed in each subject on a separate occasion. The anorectal parameters and distension-induced abdominal symptoms were recorded...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27649004/study-of-intestinal-function-in-anorectal-malformations-the-role-of-bowel-management-in-quality-of-life
#10
Laura Lombardi, Elena Garrisi, Matteo Ricco', Federico Marchesi, Emilio Casolari, Claudia Gatti, Carmine G Del Rossi
PURPOSE: We aimed at investigating bowel function in children and adolescents with anorectal malformations (ARMs) and assess their quality of life (QoL), in order to define a personal program of bowel management improving both clinical condition and self-confidence. METHODS: A total of 55 patients treated for ARM by Posterior Sagittal Ano-Recto-Plasty (PSARP) from 2000 to 2014 were included into the study. The parents of 41 patients answered two telephone questionnaires about the parents' self-efficacy and about QoL (GIQLI)...
September 13, 2016: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/27647462/the-importance-of-a-high-rectal-pressure-on-strain-in-constipated-patients-implications-for-biofeedback-therapy
#11
Y Mazor, R Hansen, G Prott, J Kellow, A Malcolm
BACKGROUND: A subset of patients with chronic constipation display a relatively high manometric rectal pressure on strain. We hypothesized that these patients represent a unique phenotype of functional defecatory disorder (FDD) and would benefit from undergoing anorectal biofeedback (BF). METHODS: Of 138 consecutive patients with chronic constipation and symptoms of FDD, 19 were defined as having a high rectal pressure on strain, using a statistically derived cut-off of 78 mm Hg...
September 20, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27542137/controversies-in-j-pouch-surgery-for-ulcerative-colitis-a-focus-on-handsewn-versus-stapled-anastomosis
#12
Tamar Nobel, Sergey Khaitov, Alexander J Greenstein
The accepted current standard for treatment of medically refractory ulcerative colitis is total proctocolectomy with an ileal pouch-anal anastomosis for restoration of continence. There are 2 techniques by which the anastomosis can be performed, including handsewn and stapled. Handsewn anastomosis with mucosectomy was the first method described; however, it has been associated with significant incontinence. The double-stapled anastomosis was developed in response to improve postoperative function. Controversy remains as to which technique is superior as both have disadvantages...
September 2016: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/27488366/allogeneic-anorectal-transplantation-in-rats-technical-considerations-and-preliminary-results
#13
Flavio H F Galvão, Daniel R Waisberg, Victor E Seid, Anderson C L Costa, Eleazar Chaib, Rachel Rossini Baptista, Vera Luiza Capelozzi, Cinthia Lanchotte, Ruy J Cruz, Jun Araki, Luiz Carneiro D'Albuquerque
Fecal incontinence is a challenging condition with numerous available treatment modalities. Success rates vary across these modalities, and permanent colostomy is often indicated when they fail. For these cases, a novel potential therapeutic strategy is anorectal transplantation (ATx). We performed four isogeneic (Lewis-to-Lewis) and seven allogeneic (Wistar-to-Lewis) ATx procedures. The anorectum was retrieved with a vascular pedicle containing the aorta in continuity with the inferior mesenteric artery and portal vein in continuity with the inferior mesenteric vein...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27270989/diagnosis-and-treatment-of-dyssynergic-defecation
#14
REVIEW
Satish S C Rao, Tanisa Patcharatrakul
Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis...
July 30, 2016: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/27218098/safety-and-efficacy-of-permacol-injection-in-the-treatment-of-fecal-incontinence
#15
Yahya A Al-Abed, Jennifer Ayers, Abraham Ayantunde, Bandipalyam V Praveen
PURPOSE: Permacol has been gaining popularity in recent times for the treatment of fecal incontinence (FI). This study aims to evaluate the safety and efficacy of anal submucosal Permacol injection in the treatment of FI. METHODS: All consecutive patients who underwent Permacol injection for FI over a 3-year period were included. Patients' data relating to obstetric history, anorectal/pelvic operations, type of FI, preoperative anorectal physiology results and follow-up details for outcome measures were collected...
April 2016: Annals of Coloproctology
https://www.readbyqxmd.com/read/27214097/simultaneous-urodynamic-and-anorectal-manometry-studies-in-children-insights-into-the-relationship-between-the-lower-gastrointestinal-and-lower-urinary-tracts
#16
L Ambartsumyan, A Siddiqui, S Bauer, S Nurko
BACKGROUND: Children with urinary incontinence (UI) have associated functional constipation (FC) and fecal incontinence (FI). The physiology between lower urinary tract (LUT) and anorectum in children has not been elucidated. AIMS: Observe the effect of rectal distention (RD) on LUT function, and bladder filling and voiding on anorectal function. METHODS: Children with voiding dysfunction referred to Boston Children's Hospital were prospectively enrolled in combined urodynamic (UDS) and anorectal manometry (ARM)...
June 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27206812/pathophysiology-of-fecal-incontinence-differs-between-men-and-women-a-case-matched-study-in-200-patients
#17
D C Townsend, E V Carrington, U Grossi, R E Burgell, J Y J Wong, C H Knowles, S M Scott
BACKGROUND: Fecal incontinence (FI) is a common and socially disabling condition with obstetric trauma considered the principal etiological factor. This study aimed to systematically evaluate symptom presentation and anorectal function in both females and males with FI. METHODS: One hundred males (M) and 100 age-matched females (F) with FI presenting between 2012 and 2014 were identified from a prospectively collected database. Comparison of clinical (history, symptom profile, and severity using validated questionnaires) and anorectal physiological (manometry, rectal sensory testing, endoanal ultrasonography, and evacuation proctography) data between M and F was performed...
October 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27197580/effectiveness-of-percutaneous-tibial-nerve-stimulation-in-managing-refractory-constipation
#18
Lalit Kumar, Jorge Liwanag, Eleni Athanasakos, Amanda Raeburn, Natalia Zarate-Lopez, Anton V Emmanuel
AIM: Chronic constipation can be aetiopathogenically classified in to slow transit constipation (STC), rectal evacuation difficulty (RED) or a combination (BOTH). Although the efficacy of percutaneous tibial nerve stimulation (PTNS) in faecal incontinence has been well proven, a current literature search identifies only one study which assessed its effect on constipation. We aimed to evaluate the effectiveness of PTNS in patients with different causes of constipation. METHOD: 34 patients (30 women, median age 50 (20-79) years with constipation who had previously failed maximal laxative and biofeedback therapy participated in the study...
May 20, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27193192/sacral-nerve-stimulation-for-faecal-incontinence-medium-term-follow-up-from-a-single-institution
#19
Vicki Patton, Earl Abraham, David Z Lubowski
BACKGROUND: Most studies on sacral nerve stimulation (SNS) are either single-centre with small numbers of patients or multi-centre studies. We present the medium-term follow-up results from a single centre for 127 patients undergoing SNS. METHODS: Consecutive patients treated with SNS for faecal incontinence had preoperative baseline St Mark's continence scores, faecal incontinence quality of life (FIQL) measures and anorectal physiology studies. Follow-up was a postal questionnaire concerning continence, FIQL, patient-perceived change in bowel control (-5 to +5 where 0 is no change), overall satisfaction (0-10 visual analogue scale) and use of medications...
May 19, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27184916/anorectal-biofeedback-for-neurogenic-bowel-dysfunction-in-incomplete-spinal-cord-injury
#20
Y Mazor, M Jones, A Andrews, J E Kellow, A Malcolm
STUDY DESIGN: A case-control study of prospectively collected data was performed. OBJECTIVES: To compare anorectal biofeedback (BF) outcomes in patients with incomplete motor spinal cord injury (SCI) and neurogenic bowel dysfunction (NBD) with a group of functional anorectal disorder-matched control patients. SETTING: Neurogastroenterology Unit affiliated with a Spinal Injury Unit in a tertiary referral centre in Sydney, Australia. METHODS: All consecutive patients with SCI and NBD referred for anorectal manometry and BF were matched in a 1:2 ratio with age, gender, parity and functional anorectal disorder-matched control patients...
May 17, 2016: Spinal Cord
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