Influence of Body Position on Defecation in Humans

Sakakibara, Ryuji; Tsunoyama, Kuniko; Hosoi, Hiroyasu; Takahashi, Osamu; Sugiyama, Megumi; Kusumoto, Masahiko; Ogawa, Emina; Terada, Hitoshi; Uchiyama, Tomoyuki; Yamanishi, Tomonori

doi:10.1111/j.1757-5672.2009.00057.x

Cited by 59 publications

(42 citation statements)

References 22 publications

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“…Maglinte et al suggested that evacuation in supine position with patients' legs extended and in protocols with just rest and strain sequences, does not precipitate the symptoms [20]. But in this study, with laying the patients in supine position and placing a pillow beneath the knees, a relative physiologic defecation position was created [21]. Also placing the hips in as much flexion as possible caused a relative relaxed position to make more perpendicular rectoanal canal.…”

Section: Mri Findings Indices (Pelvic Floor Motion Indices)mentioning

confidence: 99%

“…Also placing the hips in as much flexion as possible caused a relative relaxed position to make more perpendicular rectoanal canal. Hence, the strain could occur more easily and forcefully [21]. In addition if the procedures of MR defecography had been imposed a true sitting position with unusual circumstances that bothers the patients, so this imaging is not taken in a real physiologic defecation condition [22].…”

Section: Mri Findings Indices (Pelvic Floor Motion Indices)mentioning

confidence: 99%

See 1 more Smart Citation

Accurate Differentiation of Dyssynergic Defecation Patients from Normal Subjects Based on Abnormal Anorectal Angle in MR Defecography

Nikjooy¹,

Maroufi²,

Ebrahimi³

et al. 2016

J Yoga Phys Ther

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Section: Mri Findings Indices (Pelvic Floor Motion Indices)mentioning

confidence: 99%

Section: Mri Findings Indices (Pelvic Floor Motion Indices)mentioning

confidence: 99%

Accurate Differentiation of Dyssynergic Defecation Patients from Normal Subjects Based on Abnormal Anorectal Angle in MR Defecography

Nikjooy¹,

Maroufi²,

Ebrahimi³

et al. 2016

J Yoga Phys Ther

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“…Firstly, no physical contact with a squatting toilet is necessary. Secondly, the squatting position facilitates relaxation of the muscles around the anal canal and widens the anorectal angle to allow a straighter passage for defaecation [9]. This theory led to the use of a 'Defecation Posture Modi cation Device' (DPMD) with the seating type of toilet.…”

Section: Resultsmentioning

confidence: 99%

“…Appropriate management of excreta and wastewater disposal in sewerage systems is considered essential to public health policy [8]. Squatting toilets are common in Asian countries, and a squatting posture has been shown to widen the anorectal angle and facilitate defaecation [9]. However, use of a squatting toilet may be a concern if the toilet is left uncovered.…”

Section: Introductionmentioning

confidence: 99%

Limiting potential COVID-19 contagion in squatting public toilets

Han

Pan

Chen

et al. 2020

Preprint

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Background: Since the outbreak of the SARS-CoV-2 virus in December 2019, the COVID-19 pandemic continues to threaten global stability. Transmission of SARS-CoV-2 is mostly by respiratory droplets and direct contact but viral RNA fragments have also been detected in the faecal waste of patients with COVID-19. Cleanliness and effective sanitation of public toilets is a concern, as flushing the toilet is potentially an aerosol generating procedure. When the toilets are of the squatting type and without a cover, there exists a risk of viral contamination through the splashing of toilet water and aerosol generation. Methods: This study reports an online survey of 134 people in China to determine whether the cleanliness of public toilets was a concern to the general population during the COVID-19 pandemic, and whether a squatting toilet was preferred to a seated design.Results: The survey showed that 91% of participants preferred squatting toilets, but that 72% were apprehensive of personal contamination when using public toilets. Over 63% of the respondents had encountered an incidence of water splash and would prefer public toilets to be covered during flushing and 83% of these respondents preferred a foot-controlled device.Conclusions: This survey suggests that consideration should be given to the installation of a simple foot-controlled device to cover public squatting toilets to help restrict potential COVID-19 contamination and to meet hygienic expectations of the public.

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“…Third, whilst the RTA was examined in the left lateral position, the MRI sequence from which the anatomical models were delineated from was conducted in the supine position. Whilst there is evidence in the literature that hip flexion alters the anorectal angle [15] as well as the activity and functionality of the pelvic floor [16], there is little to none empirically quantifying the degree or nature of alteration in the left lateral position when compared with the standard supine position. The complexity of this issue is compounded by the fact that merely moving the position of the body from left lateral to supine, even without flexion of the hips, has in itself been found to significantly move some elements of the abdominal and pelvic anatomy [17,18].…”

Section: Discussionmentioning

confidence: 99%

Taking the Pressure Off the Patient – Understanding Digital Rectal Examinations on a Real Subject

Granados

Cox

Low‐Beer

et al. 2020

IEEE Trans. Biomed. Eng.

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Better understanding of palpation techniques during unsighted physical examinations has mostly been limited to qualitative and quantitative studies of performance of experts whilst conducting examinations on plastic benchtop models. However, little is known about their performance when conducting such examinations on real subjects. Objective: The aim of this paper is to better understand palpation techniques of experts whilst conducting a Digital Rectal Examination on a real subject. Methods: We recruited four consultants from relevant specialties and asked them to conduct two DREs on a Rectal Teaching Assistant whilst wearing small position and pressure sensors on their examining finger. We segmented the relevant anatomy from an MRI taken of the pelvic region, registered 3D models and analysed retrospectively performance in relation to executed tasks, supination/pronation, palpation convex hull and pressure applied. Results: Primary care consultants examined the anatomy more holistically compared to secondary care experts, the maximum pressure applied across experiments is 3.3N, overall the pressure applied on the prostate is higher than that applied to rectal walls, and the urologist participant not only applied the highest pressure but also did so with the highest most prominent frequency (15.4 and 25.3 Hz). Conclusions: The results of our research allow for better understanding of experts' technical performance from relevant specialities when conducting a DRE, and suggest the range of pressure applied whilst palpating anatomy. Significance: This research will be valuable in improving the design of haptics-based learning tools, as well as in encouraging reflection on palpation styles across different specialities to develop metrics of performance.

show abstract

Influence of Body Position on Defecation in Humans

Abstract: The results of the present study suggest that the greater the hip flexion achieved by squatting, the straighter the rectoanal canal will be, and accordingly, less strain will be required for defecation.

Cited by 59 publications

References 22 publications

Accurate Differentiation of Dyssynergic Defecation Patients from Normal Subjects Based on Abnormal Anorectal Angle in MR Defecography

Accurate Differentiation of Dyssynergic Defecation Patients from Normal Subjects Based on Abnormal Anorectal Angle in MR Defecography

Limiting potential COVID-19 contagion in squatting public toilets

Taking the Pressure Off the Patient – Understanding Digital Rectal Examinations on a Real Subject

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