Functional activity of the rectum: A conduit organ or a storage organ or both? |
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作者姓名: | Shafik A Mostafa RM Shafik I Ei-Sibai O Shafik AA |
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作者单位: | Department of Surgery and Experimental Research Faculty of Medicine,Cairo University,Cairo,Egypt,Department of Physiology,Faculty of Medicine,Sharkia University,Banha-Zagazig,Egypt,Department of Surgery and Experimental Research,Faculty of Medicine,Cairo University,Cairo,Egypt,Department of Surgery,Faculty of Medicine,Menoufia University,Shebin El-Kom,Egypt,Department of Surgery and Experimental Research,Faculty of Medicine,Cairo University,Cairo,Egypt |
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摘 要: | AIM: To investigate whether the degree of rectal distension could define the rectum functions as a conduit or reservoir. METHODS: Response of the rectal and anal pressure to 2 types of rectal balloon distension, rapid voluminous and slow gradual distention, was recorded in 21 healthy volunteers (12 men, 9 women, age 41.7±10.6 years). The test was repeated with sphincteric squeeze on urgent sensation. RESULTS: Rapid voluminous rectal distension resulted in a significant rectal pressure increase (P < 0.001), an anal pressure decline (P < 0.05) and balloon expulsion. The subjects felt urgent sensation but did not feel the 1st rectal sensation. On urgent sensation, anal squeeze caused a significant rectal pressure decrease (P < 0.001) and urgency disappearance. Slow incremental rectal filling drew a rectometrogram with a "tone" limb representing a gradual rectal pressure increase during rectal filling, and an "evacuation limb" representing a sharp pressure increase during balloon expulsion. The curve recorded both the 1st rectal sensation and the urgent sensation. CONCLUSION: The rectum has apparently two functions: transportation (conduit) and storage, both depending on the degree of rectal filling. If the fecal material received by the rectum is small, it is stored in the rectum until a big volume is reached that can affect a degree of rectal distension sufficient to initiate the defecation reflex. Large volume rectal distension evokes directly the rectoanal inhibitory reflex with a resulting defecation.
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关 键 词: | 直肠疾病 感觉功能 病理机制 治疗 |
收稿时间: | 2005 Jun 9 |
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