Spectrum of abnormal rectoanal reflex patterns in patients with fecal incontinence

Diseases of the Colon and Rectum
Y P SangwanJ J Murray

Abstract

Abnormalities of rectoanal inhibitory or excitatory reflex in patients with fecal incontinence are well described. A spectrum of abnormal responses, other than those already described in the literature, has been observed in some patients with fecal incontinence and forms the subject of this report. Forty-three patients with idiopathic or traumatic fecal incontinence were studied to evaluate their reflex responses to balloon distention of the rectum, and results were compared with reflex responses of 29 control subjects with no anorectal complaints. Control subjects revealed normal reflex responses consisting of initial excitation followed by inhibition in the proximal anal canal and an excitatory response in the distal anal canal. Patients who were incontinent revealed five different types of reflex patterns. Eleven patients (25.5 percent) with segmental sphincter defects from obstetric injuries exhibited no distal excitation but had normal response in the proximal anal canal (Group 1). Eleven patients (25.5 percent) with idiopathic incontinence exhibited normal proximal response but an inhibitory as opposed to excitatory response in the distal anal canal (Group 2). Three patients (7 percent) with iatrogenic trauma failed to re...Continue Reading

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Citations

Jan 25, 2006·Annals of Surgery·Stefan MaartenseWillem A Bemelman
Aug 4, 2009·Best Practice & Research. Clinical Gastroenterology·Adeel Bajwa, Anton Emmanuel
Nov 28, 2015·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·L A DevaneJ F X Jones
Dec 14, 2004·Gynecologic Oncology·Thomas C KrivakPaul J MacKoul
Sep 17, 2008·Gastroenterology Clinics of North America·S Mark Scott, Marc A Gladman
Jul 1, 2000·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland· Zbar Guillou
Apr 11, 2018·Nature Reviews. Gastroenterology & Hepatology·Emma V CarringtonUNKNOWN International Anorectal Physiology Working Group and the International Working Group for Disorders of Gastrointestinal Motil
Aug 20, 2021·Techniques in Coloproctology·A P Zbar

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