Human studies of anorectal sensory function

Knowles, Charles H.

doi:10.1007/s11845-018-1847-5

Cited by 7 publications

(3 citation statements)

References 36 publications

(43 reference statements)

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“…Conscious perception implies sensory connectivity between the rectum and the brain ( 33 ). Sensory threshold to rectal distention is also an important indicator of the rectal-brain afferent pathway.…”

Section: Discussionmentioning

confidence: 99%

Impaired Anorectal Afferents Is a Potential Pathophysiological Factor Associated to Functional Anorectal Pain

et al. 2020

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Background/Aims: Functional anorectal pain (FARP) is a functional gastrointestinal disease, which belongs to chronic pelvic floor pain. The mechanisms of its development are not fully understood. We designed this experiment to evaluate the characteristics of rectal sensory evoked potential (RSEP) and anorectal manometry (ARM) in this population, so as to explore the pathophysiology of FARP. Methods: The rectal sensory evoked potentials (RSEP) and anorectal manometry (ARM) were performed in 23 patients with FARP and 23 healthy controls. The correlation between the two measurements was investigated. Results: The results of RSEP showed that (1) the median latency to the first positive peak was 69.2 ± 15.9 ms in patients, compared with 46.5 ± 5.8 ms in controls ( P = 0.000). (2) The amplitude of evoked potential peaks in the FARP patients was significantly lower than the healthy controls (P1/N1: P = 0.049; N1/P2: P = 0.010). (3) Compared with the controls, the patients showed a lower maximum voluntary squeeze pressure ( P = 0.009), lower rectum ( P = 0.007), and anal sphincter pressures ( P = 0.000) during strain; and increased maximum tolerance threshold to rectal distention ( P = 0.000). (4) The resting pressure of the anal sphincter was correlated with the peak amplitude of the RSEP (P1/N1: r = 0.537, P = 0.039; N1/P2: r = 0.520, P = 0.047). Considering the different pathophysiological mechanisms of levator ani syndrome and proctalgia fugax, we analyzed data on unspecified functional anorectal pain and obtained similar results. Conclusions: The RSEP can be used to evaluate the state of afferent pathways in FARP patients; The longer latency and lower peak amplitude of RSEP indicate the functional defects of the anorectal afferent pathway. It can provide an objective evidence for the neuropathy of FARP. In addition, the pathophysiology of FARP is also associated with pelvic floor muscle motor and coordination dysfunction. The correlation between the peak amplitude of the RSEP and the resting pressure of the anal sphincter suggests that there seems to be a correlation between anal pressure and the afferent signaling pathway in patients with FARP.

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Section: Discussionmentioning

confidence: 99%

Impaired Anorectal Afferents Is a Potential Pathophysiological Factor Associated to Functional Anorectal Pain

et al. 2020

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“…Объем баллона регистрируется, когда пациент отмечает наличие следующих трех порогов ощущений: объем ощущения постоянного наполнения, объем позыва на дефекацию и максимально переносимый объем [3]. Исследования показали, что у части пациентов с запорами наблюдается снижение чувствительности (ректальная гипочувствительность), что можно выявить главным образом благодаря данному методу диагностики [34,35].…”

Section: методы диагностики аноректальных нарушенийunclassified

Diagnosis of Functional Gastrointestinal Disorders and Choice of Treatment Regimen in Constipation Patients

Маев

Казюлин

Кучерявый

et al. 2021

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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Aim. A practical review of functional gastrointestinal disorder diagnosis in constipation patients and the rationale for opting treatment.Key points. Functional constipation commonly afflicts different ages and negatively impacts the quality of life. The current diagnostic algorithm in chronic constipation includes the disease identification according to Rome Criteria IV, red-flag symptom detection and instrumental laboratory examination. Functional constipation is notably often associated with anorectal abnormalities that bear a diagnostic value to elaborate an apt treatment strategy. Anorectal manometry, rectal sensation and balloon expulsion tests are the well-studied and significant probing techniques for objective anorectal zone sensorimotor function assessment in patients with functional constipation. The article reviews modern diagnostic methods in functional defecation disorders.Conclusion. The examination and treatment algorithms presented will help improve diagnosis and apply the most suitable management in a constipation-associated functional digestive pathology.

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“… 13 , 21 Regarding NM, the action mechanism is little known, but it has been strongly suggested that it affects both motor and sensorial functions. 22 Overall, the efficacy of the treatments is probably highly dependent on the pathophysiology underlying FI, hence the discordant results, so it is key on one hand to understand the pathophysiology, and on the other, to understand the action mechanisms of the treatments.…”

Section: Introductionmentioning

confidence: 99%

Kegel Exercises, Biofeedback, Electrostimulation, and Peripheral Neuromodulation Improve Clinical Symptoms of Fecal Incontinence and Affect Specific Physiological Targets: An Randomized Controlled Trial

Mundet

Rofes

Ortega

et al. 2021

J Neurogastroenterol Motil

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Human studies of anorectal sensory function

Abstract: This review addresses three main questions: (1) Why is anorectal sensory function important in humans? (2) What is the evidence for anorectal sensory dysfunction in disease? (3) Can anorectal sensory function be modified for therapeutic benefit?

Cited by 7 publications

References 36 publications

Impaired Anorectal Afferents Is a Potential Pathophysiological Factor Associated to Functional Anorectal Pain

Impaired Anorectal Afferents Is a Potential Pathophysiological Factor Associated to Functional Anorectal Pain

Diagnosis of Functional Gastrointestinal Disorders and Choice of Treatment Regimen in Constipation Patients

Kegel Exercises, Biofeedback, Electrostimulation, and Peripheral Neuromodulation Improve Clinical Symptoms of Fecal Incontinence and Affect Specific Physiological Targets: An Randomized Controlled Trial

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