Paradoxical sphincter reaction is influenced by rectal filling volume
作者:
Annika López,
Bo Holmström,
Bengt Nilsson,
Anders Dolk,
Claes Johansson,
Inkeri Schultz,
Jan Zetterström,
Anders Mellgren,
期刊:
Diseases of the Colon & Rectum
(OVID Available online 1998)
卷期:
Volume 41,
issue 8
页码: 1017-1022
ISSN:0012-3706
年代: 1998
出版商: OVID
关键词: Anismus;Constipation;Electrophysiology;Paradoxical sphincter reaction
数据来源: OVID
摘要:
PURPOSE:Paradoxical sphincter reaction is frequently found in constipated patients but sometimes also in incontinent patients and in asymptomatic subjects. Its significance in defecation disorders has, therefore, been debated. The aim of the present study was to investigate whether paradoxical sphincter reaction is influenced by rectal filling volume.PATIENTS AND METHODS:Eighteen patients with defecation disorders and paradoxical sphincter reaction shown by electromyography were reinvestigated with an extended electromyographic investigation while in the lying position and while in the sitting position, with 50‐ml, 100‐ml, and 150‐ml water‐filled rectal balloons.RESULTS:All 18 patients showing paradoxical sphincter reaction in the first investigation also showed the reaction at the second investigation in the lying position with a 0‐ml volume of rectal contents. In the sitting position, with a volume of 150 ml of rectal contents, the increase in electromyographic activity disappeared in seven patients (39 percent) and no longer showed paradoxical sphincter reaction. Electromyography showed decreased activity in one patient and unchanged activity in six patients during straining. A closing reflex was seen after completed straining in all of these seven patients.CONCLUSIONS:The present study demonstrates that paradoxical sphincter reaction diagnosed by electromyography is influenced by the rectal filling volume and might diminish when the rectum is filled with contents. The conventional electrophysiologic technique in the diagnosis of paradoxical sphincter reaction might, therefore, overdiagnose this condition.
点击下载:
PDF
(660KB)
返 回