Advertisement

Manometric and Electromyographic Techniques for Assessment of the Anorectal Mechanism for Continence and Defecation

  • William E. Whitehead
  • Marvin M. Schuster

Abstract

There are several reasons for concerning oneself with the accurate measurement of physiological responses in the anal canal and rectum. The anorectal area provides a critical interface between the external, social, and physical environment and the internal, biological environment. Society places considerable importance on the self-control of defecation, and the assessment and treatment of incontinence is therefore important. In addition, this part of the gastrointestinal tract is well supplied with visceral afferent nerves which give rise to subjective and reflex control: This provides a unique opportunity to study the mechanism by which self-regulation of a visceral response is achieved. This chapter will summarize what is known of the anatomy and physiology of the anorectal area and will describe the advantages and disadvantages of various measurement techniques.

Keywords

Fecal Incontinence Anal Sphincter Anal Canal External Anal Sphincter Internal Anal Sphincter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Alva, J., Mendeloff, A. I., & Schuster, M. M. Reflex and electromyographic abnormalities associated with fecal incontinence. Gastroenterology, 1967, 53, 101–106.PubMedGoogle Scholar
  2. Bass, D. D., Vanasin, B., Ustach, T. J., & Schuster, M. M. An in vitro model demonstrating specificity of sphincteric smooth muscle. Johns Hopkins Medical Journal, 1912, 131, 436–440.Google Scholar
  3. Bishop, B. Reflex activity of external anal sphincter of cat. Journal of Neurophysiology, 1959, 22, 679–692.PubMedGoogle Scholar
  4. Cerulli, M. A., Nikoomanesh, P., & Schuster, M. M. Progress in biofeedback conditioning for fecal incontinence. Gastroenterology, 1979, 76, 742–746.PubMedGoogle Scholar
  5. Corman, M. L. Management of fecal incontinence by gracilis muscle transposition. Diseases of the Colon and Rectum, 1979, 22, 290–292.PubMedCrossRefGoogle Scholar
  6. Engel, B. T. The treatment of fecal incontinence by operant conditioning. Automedica, 1978, 2, 101–108.Google Scholar
  7. Engel, B. T., Nikoomanesh, P., & Schuster, M. M. Operant conditioning of rectosphincteric responses in the treatment of fecal incontinence. New England Journal of Medicine, 1974, 290, 646–649.PubMedCrossRefGoogle Scholar
  8. Goligher, J. C., & Hughes, E. S. R. Sensibility of the rectum and colon: Its role in the mechanism of anal continence. Lancet, 1951, 1, 543–548.PubMedCrossRefGoogle Scholar
  9. Parker, L., & Whitehead, W. E. Treatment of urinary and fecal incontinence in children. In D. C. Russo & J. W. Varni (Eds.), Behavioral pediatrics: Research and practice. New York: Plenum Press, 1982.Google Scholar
  10. Read, N. W., Harford, W. V., Schmulen, A. C., Read, M. G., Santa Ana, C., & Fordtran, J. S. A clinical study of patients with fecal incontinence and diarrhea. Gastroenterology, 1979, 76, 141–156.Google Scholar
  11. Rodriquez, A. A., & Awad, E. Detrusor muscle and sphincteric response to anorectal stimulation in spinal cord injury. Archives of Physical Medicine and Rehabilitation, 1979, 60, 296–272.Google Scholar
  12. Schuster, M. M. Motor action of rectum and anal sphincters in continence and defecation. In C. Code & C. L. Prossed (Eds.), Handbook of physiology. Section 6: Alimentory canal (Vol IV.) Motility. Washington, D.C.: American Physiological Society, 1968.Google Scholar
  13. Ustach, T. J., Tobon, F., Hambrecht, T., Bass, D. D., & Schuster, M. M. Electrophysiological aspects of human sphincter function. Journal of Clinical Investigations, 1970, 49, 41–48.CrossRefGoogle Scholar
  14. Wald, A. Use of biofeedback in the treatment of fecal incontinence in patients with men-ingomyelocele. Pediatrics, 1981, 68, 45–49.PubMedGoogle Scholar
  15. Whitehead, W. E., Engel, B. T., & Schuster, M. M. Perception of rectal distension is necessary to prevent fecal incontinence. In G. Ádám, I. Meszaros, & E. I. Banyai (Eds.), Advances in Physiological Sciences (Vol. 17). Brain and Behavior. Budapest, Hungary: Akademiai Kiado, 1981.Google Scholar
  16. Whitehead, W. E., Orr, W. C., Engel, B. T., & Schuster, M. M. External anal sphincter response to rectal distension: Learned response or reflex. Psychophysiology, 1981, 19, 57–62.CrossRefGoogle Scholar
  17. Whitehead, W. E., Parker, L. H., Masek, B. J., Cataldo, M. F., & Freeman, J. M. Biofeedback treatment of fecal incontinence in meningomyelocele. Developmental Medicine and Child Neurology, 1981, 23, 313–321.PubMedGoogle Scholar

Copyright information

© Plenum Press, New York 1983

Authors and Affiliations

  • William E. Whitehead
    • 1
    • 2
  • Marvin M. Schuster
    • 3
  1. 1.Department of PsychiatryThe Johns Hopkins School of MedicineUSA
  2. 2.Department of MedicineBaltimore City HospitalBaltimoreUSA
  3. 3.The Johns Hopkins School of Medicine and the Division of Digestive DiseasesBaltimore City HospitalBaltimoreUSA

Personalised recommendations