Simulated stool for assessment of anorectal physiology

2020 ◽  
Vol 319 (4) ◽  
pp. G462-G468
Author(s):  
Ssu-Chi Chen ◽  
Kaori Futaba ◽  
Wing Wa Leung ◽  
Cherry Wong ◽  
Tony Mak ◽  
...  
Keyword(s):  
Anorectal Function ◽  
Anorectal Physiology ◽  
Motor Disorders ◽  
Dynamic Measurements ◽  
Rectal Compliance ◽  
Defecatory Function ◽  
Novel Technology ◽  
Patient Groups ◽  
Anorectal Diseases ◽  
Advanced Analysis

Fecal continence is maintained by several mechanisms including anatomical factors, anorectal sensation, rectal compliance, stool consistency, anal muscle strength, mobility, and psychological factors. The homeostatic balance is easily disturbed, resulting in symptoms including fecal incontinence and constipation. Current technologies for assessment of anorectal function have limitations. Overlap exist between data obtained in different patient groups, and there is lack of correlation between measurements and symptoms. This review describes a novel technology named Fecobionics for assessment of anorectal physiology. Fecobionics is a simulated stool, capable of dynamic measurements of a variety of variables during defecation in a single examination. The data facilitate novel analysis of defecatory function as well as providing the foundation for modeling studies of anorectal behavior. The advanced analysis can enhance our physiological understanding of defecation and future interdisciplinary research for unraveling defecatory function, anorectal sensory-motor disorders, and symptoms. This is a step in the direction of improved diagnosis of anorectal diseases.

scholarly journals Theoretical Tools to Analyze Anorectal Mechanophysiological Data Generated by the Fecobionics Device

2019 ◽  
Vol 141 (9) ◽  
Author(s):  
D. Liao ◽  
S. C. Chen ◽  
K. M. Lo ◽  
J. Zhao ◽  
K. Futaba ◽  
...  
Keyword(s):  
Anorectal Function ◽  
Fecal Continence ◽  
Gastrointestinal Disorders ◽  
Motor Disorders ◽  
Mechanical Function ◽  
Rectal Compliance ◽  
Defecatory Function ◽  
Novel Technologies ◽  
Theoretical Approaches ◽  
Mechanical Approach

A mechanical approach is needed for understanding anorectal function and defecation. Fecal continence is achieved by several interacting mechanisms including anatomical factors, anorectal sensation, rectal compliance, stool consistency, anal muscle strength, motility, and psychological factors. The balance is easily disturbed, resulting in symptoms such as fecal incontinence and constipation. Novel technologies have been developed in recent years for studying anorectal function. Especially, the Fecobionics device, a simulated feces, has gained attention recently. This facilitates new analysis of anorectal mechanical function. In this study, a theoretical model is developed to analyze anorectal mechanophysiological data generated by the Fecobionics device. Theoretical approaches can enhance future interdisciplinary research for unraveling defecatory function, sensory-motor disorders, and symptoms. This is a step in the direction of personalized treatment for gastrointestinal disorders based on optimized subtyping of anorectal disorders.

scholarly journals Recommendations for the Protocol of functional examination of the anorectal zone and disorders classification: the International Anorectal Physiology Working Group consensus and Russian real-world practice

2020 ◽  
Vol 92 (12) ◽  
pp. 105-119
Author(s):  
O. Yu. Fomenko ◽  
S. V. Morozov ◽  
S. Mark Scott ◽  
H. Charles Knowles ◽  
D. A. Morozov ◽  
...  
Keyword(s):  
Real World ◽  
Working Group ◽  
Anorectal Function ◽  
Anorectal Physiology ◽  
Rectal Sensation ◽  
High Resolution Manometry ◽  
Additional Information ◽  
Wide Range ◽  
Balloon Expulsion ◽  
Function Testing

This manuscript summarizes consensus reached by the International Anorectal Physiology Working Group (IAPWG) for the performance, terminology used, and interpretation of anorectal function testing including anorectal manometry (focused on high-resolution manometry), the rectal sensory test, and the balloon expulsion test. Based on these measurements, a classification system for disorders of anorectal function is proposed. Aim to provide information about methods of diagnosis and new classification of functional anorectal disorders to a wide range of specialists general practitioners, therapists, gastroenterologists, coloproctologists all who face the manifestations of these diseases in everyday practice and determine the diagnostic and therapeutic algorithm. Current paper provides agreed statements of IAPWG Consensus and comments (in italics) of Russian experts on real-world practice, mainly on methodology of examination. These comments in no way intended to detract from the provisions agreed by the international group of experts. We hope that these comments will help to improve the quality of examination based on the systematization of local experience with the use of the methods discussed and the results obtained. Key recommendations: the International Anorectal Physiology Working Group protocol for the performance of anorectal function testing recommends a standardized sequence of maneuvers to test rectoanal reflexes, anal tone and contractility, rectoanal coordination, and rectal sensation. Major findings not seen in healthy controls defined by the classification are as follows: rectoanal areflexia, anal hypotension and hypocontractility, rectal hyposensitivity, and hypersensitivity. Minor and inconclusive findings that can be present in health and require additional information prior to diagnosis include anal hypertension and dyssynergia.

Anorectal physiology validated: A repeatability study of the motor and sensory tests of anorectal function

1989 ◽  
Vol 76 (6) ◽  
pp. 607-609 ◽  
Author(s):  
J. Rogers ◽  
S. Laurberg ◽  
J. J. Misiewicz ◽  
M. M. Henry ◽  
M. Swash
Keyword(s):  
Anorectal Function ◽  
Anorectal Physiology ◽  
Sensory Tests

Correction of motor disorders in patients with multiple sclerosis

2020 ◽  
Vol 18 (5) ◽  
pp. 146-149
Author(s):  
Zh. F. SABIROV ◽  
◽  
G. M. AKHMEDOVA ◽  
T. I. KHAIBULLIN ◽  
◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairments ◽  
Social Activity ◽  
The Body ◽  
Demyelinating Diseases ◽  
Motor Deficit ◽  
Motor Disorders ◽  
Diagnostic Center ◽  
Severe Motor ◽  
Patient Groups

The main cause of occupational and social activity disorders in patients with multiple sclerosis (MS) is motor deficit. The genesis of movement disorders reflects multifocal lesions of various parts of the spinal cord and brain. The patient groups were formed according to the EDSS scale: with mild (EDSS 2,5–4,0 b), moderate (EDSS 4,5–5,5 b) and severe motor disorders (6,0–6,5 b). There was performed neurological examination of patients with an assessment of the cognitive and vestibular functions of the body. The dominant syndromes in the development of motor disorders are central paresis, focal, pelvic and cognitive impairments. The developed complex of rehabilitation measures with the use of a stabilometric complex, a treadmill and physiotherapeutic treatment, made it possible to improve the motor function in patients with multiple sclerosis at all stages of the disease. These measures were implemented in the Republican Clinical and Diagnostic Center for demyelinating diseases in Kazan.

scholarly journals Influence of Rectal Decompression on Abdominal Symptoms and Anorectal Physiology following Colonoscopy in Healthy Adults

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Chih-Hsun Yi ◽  
Tso-Tsai Liu ◽  
Wei-Yi Lei ◽  
Jui-Sheng Hung ◽  
Chien-Lin Chen
Keyword(s):  
Abdominal Pain ◽  
Healthy Subjects ◽  
Abdominal Discomfort ◽  
Healthy Adults ◽  
Anorectal Physiology ◽  
Rectal Tube ◽  
Rectal Compliance ◽  
Rectal Distension ◽  
Abdominal Symptoms ◽  
Peripheral Mechanism

Background. Postcolonoscopy abdominal discomfort and bloating are common. The aim of this study was to evaluate whether rectal decompression improved distension-induced abdominal symptoms and influenced anorectal physiology.Methods. In 15 healthy subjects, rectal distension was achieved by direct air inflation into the rectum by colonoscopy. Placement of rectal and sham tube was then performed in each subject on a separate occasion. The anorectal parameters and distension-induced abdominal symptoms were recorded.Results. Anorectal parameters were similar between placements of rectal tube and sham tube except for greater rectal compliance with rectal tube than with sham tube (P<0.05). Abdominal pain and bloating were significantly reduced by rectal tube and sham tube at 1 minute (bothP<0.05) and 3 minutes (bothP<0.05). After placement of rectal tube, abdominal pain at 3 minutes correlated positively with first sensation (r=0.53,P=0.04), and bloating at 3 minutes also correlated positively with urge sensation (r=0.55,P=0.03).Conclusions. Rectal decompression with either rectal or sham tube improved distension-induced abdominal symptoms. Our study indicates that the mechanisms that improved abdominal symptoms by rectal decompression might be mediated by a central pathway instead of a peripheral mechanism.

scholarly journals Acute effects of therapeutic irradiation for prostatic carcinoma on anorectal function

Gut ◽  
1998 ◽  
Vol 43 (1) ◽  
pp. 123-127 ◽  
Author(s):  
E K Yeoh ◽  
A Russo ◽  
R Botten ◽  
R Fraser ◽  
D Roos ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Faecal Incontinence ◽  
Prostatic Carcinoma ◽  
Anorectal Function ◽  
Sensory Function ◽  
Abdominal Pressure ◽  
Rectal Compliance ◽  
Rectal Distension ◽  
Rectal Sensation ◽  
Faecal Urgency

Aim—The incidence of anorectal symptoms after radiotherapy (RTH) for localised pelvic malignant disease is unclear. In addition, the effects of pelvic irradiation on both anorectal motility and sensory function are poorly defined. A prospective study was therefore performed on 35 patients (55–82 years of age) with localised prostatic carcinoma before and four to six weeks after RTH to assess its effects on anorectal function.Methods—Anorectal symptoms were assessed by questionnaire. Anorectal pressures at rest and in response to voluntary squeeze, rectal distension, and increases in intra-abdominal pressure were evaluated with perfused sleeve side hole manometry. Rectal sensation was tested during graded balloon distension. Rectal compliance was calculated by the pressure-volume relation obtained during the testing of rectal sensation. Ultrasound was used to determine anal sphincter structure and integrity.Results—RTH had no effect on anal sphincter morphology. The frequency of defecation increased after RTH (7 (3–21) v 10 (3–56) bowel actions a week; p<0.01). After RTH, 16 patients had faecal urgency and eight faecal incontinence, compared with five and one respectively before RTH (p<0.01 for each). Basal and squeeze sleeve recorded pressures were reduced after RTH (54 (3)v 49 (3) mm Hg (p<0.05) and 111 (8)v 102 (8) mm Hg (p<0.01), before and after RTH respectively; means (SEM)). Rectal compliance was reduced after RTH (1.2 v 1.4 mm Hg/ml, p<0.05). After RTH, threshold volumes for perception of rectal distension were lower in the 16 patients who either experienced faecal urgency for the first time (13 patients) or reported worsening of this symptom (three patients) compared with the remaining patients (34 (4)v 48 (5) ml respectively, p<0.05).Conclusion—Faecal incontinence (23%) is a common problem four to six weeks after RTH for prostatic carcinoma and is associated with minor reductions in anal sphincter pressures. The high prevalence of faecal urgency in patients after RTH may be related to alterations in rectal perception of stool.

Implications of spastic motor disorders in patients with reflux symptoms

2001 ◽  
Vol 120 (5) ◽  
pp. A429-A429
Author(s):  
A ALRAKAWI ◽  
R CLOUSE
Keyword(s):  
Motor Disorders ◽  
Reflux Symptoms
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