Skip to main content
SpringerLink
Log in

Anorectum Physiology

  • Chapter
  • First Online:
Practices of Anorectal Surgery

  • 439 Accesses

Abstract

Prior to selecting the necessary anorectal physiology test, it is important to obtain helpful information from detailed hearing of medical history and after a detailed digital rectal examination (DRE). At the moment of desire to defecate, the internal sphincter slightly relaxes, and the external sphincter contracts to define whether the content is gas, watery, or solid stool by recto-anal inhibitory reflex. Basic anorectal function tests including anorectal manometry, electromyography, dynamic proctography, colon motility test, and anal ultrasonography are performed prior to the surgery to give actual help to the clinician in the case with the possibility of dysfunction of bowel movement or with bowel movement disorder. Despite the limitations, the role of an anorectal physiology function laboratory will become increasingly important in dealing with complex anorectal diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bharucha AE, Rao SSC. An update on anorectal disorders for gastroenterologists. Gastroenterology. 2014;146:37–45.

    Article  Google Scholar 

  2. Bharucha AE. Recent advances in functional anorectal disorders. Curr Gastroenterol Rep. 2011;13:316–22.

    Article  Google Scholar 

  3. Lam TJ, Felt-Bersma RJ. Clinical examination remains more important than anorectal function tests to identify treatable conditions in women with constipation. Int Urogynecol J. 2013;24:67–72.

    Article  CAS  Google Scholar 

  4. Tantiphlachiva K, Rao P, Attaluri A, et al. Digital rectal examination is a useful tool for identifying patients with dyssynergia. Am J Gastroenterol. 2010;8:955–60.

    Google Scholar 

  5. Eckardt VF, Kanzler G. How reliable is digital examination for the evaluation of anal sphincter tone? Int J Colorectal Dis. 1993;8:95–7.

    Article  CAS  Google Scholar 

  6. Dobben AC, Terra MP, Deutekom M, et al. Anal inspection and digital examination compared to anorectal physiology tests and endoanal ultrasonography in evaluating fecal incontinence. Int J Colorectal Dis. 2007;22:783–90.

    Article  Google Scholar 

  7. Coller JA. Clinical application of anorectal manometry. Gastroenterol Clin North Am. 1987;16:17–33.

    CAS  PubMed  Google Scholar 

  8. McHugh SM, Diamant NE. Anal canal pressure profile: a reappraisal as determined by rapid pull through technique. Gut. 1987;28:1234–41.

    Article  CAS  Google Scholar 

  9. Nivatvongs S, Stern HS, Fryd DS. The length of the anal canal. Dis Colon Rectum. 1981;24:600–1.

    Article  CAS  Google Scholar 

  10. Lowry AC, Simmang CL, Boulos P, Farmer KC, Finan PJ, Hyman N, et al. Consensus statement of definitions of anorectal physiology and rectal cancer. ANZ J Surg. 2001;71(10):603–5.

    Article  CAS  Google Scholar 

  11. Diamant NE, Kamm MA, Wald A, Whitehead WE. AGA technical review on anorectal testing techniques. Gastroenterology. 1999;116(3):735–60.

    Article  CAS  Google Scholar 

  12. Ebert EC. Gastric and enteric involvement in progressive systemic sclerosis. J Clin Gastroenterol. 2008;42(1):5–12.

    Article  Google Scholar 

  13. Kiff ES, Swash M. Slowed conduction in the pudendal nerves in idiopathic (neurogenic) fecal incontinence. Br J Surg. 1984;71(8):614–6.

    Article  CAS  Google Scholar 

  14. Wexner SD, Marchetti F, Salanga VD, et al. Neurophysiologic assessment of the anal sphincters. Dis Colon Rectum. 1991;34:606–12.

    Article  CAS  Google Scholar 

  15. Ricciardi R, Mellgren AF, Madoff RD, et al. The utility of pudendal nerve terminal motor latencies in idiopathic incontinence. Dis Colon Rectum. 2006;49:852–7.

    Article  Google Scholar 

  16. Loganathan A, Schloithe AC, Hakendorf P, et al. Prolonged pudendal nerve terminal motor latency is associated with decreased resting and squeezing pressures in the intact anal sphincter. Colorectal Dis. 2013;15:1410–5.

    Article  CAS  Google Scholar 

  17. Podnar S. Electrodiagnosis of the anorectum: a review of techniques and clinical applications. Tech Coloproctol. 2003;7:71–6.

    Article  CAS  Google Scholar 

  18. Lefaucher JP. Neurophysiologic testing in anorectal disorders. Muscle Nerve. 2006;33:324–33.

    Article  Google Scholar 

  19. Pfeifer J, Teoh TA, Salanga VD, Agachan F, Wexner SD. Comparative study between intra-anal sponge and needle electrode for electromyographic evaluation of constipated patients. Dis Colon Rectum. 1998;41:1153–7.

    Article  CAS  Google Scholar 

  20. Axelson HW, Edebol Eeg-Olofsson K. Simplified evaluation of the paradoxical puborectalis contraction with surface electrodes. Dis Colon Rectum. 2010;53:928–31.

    Article  Google Scholar 

  21. Lee BE, Kim GH. How perform and interpret balloon expulsion test. J Neurogastroenterol Motil. 2014;20:407–9.

    Article  Google Scholar 

  22. Minguez M, Herreros B, Sanchiz V, et al. Predictive value of the balloon expulsion test for excluding the diagnosis of pelvic floor dyssynergia in constipation. Gastroenterology. 2004;126:57–62.

    Article  Google Scholar 

  23. Bharucha AE. Update of tests of colon and rectal structure and function. J Clin Gastroenterol. 2006;40(2):96–103.

    Article  Google Scholar 

  24. Rao SS, Mudipalli RS, Stressman M, et al. Investigation of the utility of colorectal function tests and Rome II criteria in dyssynergic defecation (Anismus). Neurogastroenterol Motil. 2004;16:589–96.

    Article  CAS  Google Scholar 

  25. Felt-Bersma RJ, Luth WJ, Janssen II, Meuwissen SG. Defecography in patients with anorectal disorders. Dis Colon Rectum. 1990;33:277–84.

    Article  CAS  Google Scholar 

  26. Selvaggi F, Pesce G, Scotti Di Carlo E. Evaluation of normal subjects by defecographic technique. Dis Colon Rectum. 1990;33:698–702.

    Article  CAS  Google Scholar 

  27. Karulf RE, Coller JA, Batolo DC, et al. Anorectal physiology testing. A survey of availability and use. Dis Colon Rectum. 1991;34:464–8.

    Article  CAS  Google Scholar 

  28. Hinton JM, Lennard-Jones JE, Young AC. A mew method for studying gut transit times using radiopaque markers. Gut. 1969;10:842–7.

    Article  CAS  Google Scholar 

  29. Arhan P, Devroede G, Jehannin B, et al. Segmental colon transit time. Dis Colon Rectum. 1981;24:625–9.

    Article  CAS  Google Scholar 

  30. Metcalf AM, Phillips SF, Zinsmeister AR, MacCarty RL, Beart RW, Wolff BG. Simplified assessment of segmental colon transit. Gastroenterology. 1987;92:40–7.

    Article  CAS  Google Scholar 

  31. Stoker J, Halligan S, Bartram CI. Pelvic floor imaging. Radiology. 2001;218:621–41.

    Article  CAS  Google Scholar 

  32. Tjandra JJ, Milsom JW, Stolfi VM, et al. Endoluminal ultrasound defines anatomy of the anal canal and pelvic floor. Dis Colon Rectum. 1992;35:465–70.

    Article  CAS  Google Scholar 

  33. Vitton V, Vignally P, Barthet M, et al. Dynamic anal endosonograpy and MRI defecography in diagnosis of pelvic floor disorders: comparison with conventional defecography. Dis Colon Rectum. 2011;54:1398–404.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Jangnhang Clinic, Hanam, South Korea

    Yong Geul Joh

Authors
  1. Yong Geul Joh
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Hansol Hospital, Seoul, Korea (Republic of)

    Dong Keun Lee

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Joh, Y.G. (2019). Anorectum Physiology. In: Lee, D. (eds) Practices of Anorectal Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-13-1447-6_2

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-1447-6_2

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-1446-9

  • Online ISBN: 978-981-13-1447-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation