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Am J Physiol Gastrointest Liver Physiol (April 10, 2002). doi:10.1152/ajpgi.00359.2001
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Articles in PresS, published online ahead of print April 10, 2002
Am J Physiol Gastrointest Liver Physiol, 10.1152/ajpgi.00359.2001
Submitted on August 15, 2001
Accepted on April 1, 2002

Rectal and Colonic Distention Elicit Viscero-visceral Reflexes in Humans

Ngai-Moh Law1, Adil E Bharucha1*, and Alan R Zinsmeister2

1 Gastroenterology Research Unit, Mayo Clinic, Rochester, MN, USA
2 Section of Biostatistics, Mayo Clinic, Rochester, MN, USA

* To whom correspondence should be addressed. E-mail: bharucha.adil{at}mayo.edu.

Colonic transit is slowed in patients with disordered rectal evacuation, but the mechanism of this phenomenon is unclear. Our objective was to investigate rectocolonic inhibitory reflexes in humans to provide potential insight into patients with obstructed defecation. In 30 healthy subjects, a barostat-manometric assembly recorded colonic tone and phasic activity in the descending colon during rectal distention, and, conversely, rectal tone during colonic distention. Phasic distentions were 8, 16 and 32 mm Hg above balloon operating pressure and staircase inflations comprised balloon inflation, then deflation in 2 mm Hg increments at 30 second intervals from 0 to 36 mm Hg). Colonic balloon volumes increased to a similar extent during phasic rectal distentions 8, 16 and 32 mm Hg above operating pressure, reflecting reduced colonic tone; balloon volumes also increased and phasic pressure activity decreased during staircase rectal distentions. In contrast, rectal balloon volume declined, reflecting increased tone, during phasic and staircase colonic distentions. Thus, rectal distention inhibited colonic motor activity, indicative of a viscero-visceral inhibitory reflex.




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