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We challenged the two hypotheses: first, that defecation can be suppressed for an extended time, and second, if so, that this has an effect on upper colonic motility. Thus we studied 12 male volunteers with conditions of identical nutrition and patterns of physical activity over a two-week period, where one week with normal defecation and one week with voluntary prolonged suppression of defecation followed each other in randomized order. Frequencies of defecation, stool weights, total and segmental colonic transit times (using radiopaque markers) were compared. Frequency of defecations and stool weights were lower during suppressed defecation [8.9 +/- 0.66 vs 3.7 +/- 0.41 (mean +/- SE) bowel movements per week, P = 0.003, and 1.30 +/- 0.09 vs 0.98 +/- 0.13 kg/week, P = 0.01]. Total transit times were increased from 28.8 +/- 4.4 to 53.1 +/- 4.3 hr, P = 0.004. Segmental transit times were increased in the rectosigmoid (from 8.83 +/- 3.6 to 32.1 +/- 5.6 hr, P = 0.04) and right hemicolon (from 14.5 +/- 0.9 hr to 19.7 +/- 1.5 hr, P = 0.02) by suppression of defecation. We conclude that defecation habits may induce changes in colonic function such as those seen in constipation and that functional anorectal outlet obstruction may, probably by reflex mediation, affect the right colon.

Gastric bile acid concentration has been reported to be increased in patients with gastric ulcer' When the pyloric pressure in patients with gastric ulcer was measured a lack of response to duodenal acidification was seen. As pyloric pressure has been considered to be involved in the prevention of reflux, duodenogastric reflux has, on the basis of these results, been claimed to be increased and to play a major pathogenetic role in gastric ulcer.'-' We have, however, previously shown that fractional duodenogastric reflux is similar in controls and in gastric ulcer patients. "' In order to solve these discrepancies, the present study was designed to evaluate simultaneously bile reflux rates, gastric emptying and secretion rates, and gastric bile acid concentrations in reasonably large samples of gastric ulcer patients and healthy controls.

Definitive CRT for prostate cancer does not compromise global QoL during therapy and up to 2 years after treatment. It has a limited negative effect on role functioning, urinary symptoms and, to a lesser extent, on fatigue with restitution within 2 months to 1 year after treatment.

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