Skip to main content
Log in

The trigger for rectal filling sensation

  • Original Articles
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

In order to evaluate whether rectal volume, weight or pressure is the main trigger for rectal sensation, their respective values were determined at each of the rectal filling sensation thresholds (first, constant, urge, maximum) in 12 adult control subjects. The rectal balloon was filled at 60 ml/min in sitting position using water (twice), air and mercury consecutively. Pressure values were corrected for the elastic properties of the balloon, while the volume of inflated air was recalculated taking into account the prevalent rectal pressure and temperature. The results obtained using water, air and mercury demonstrated a constant relationship between a given rectal sensation level and the pressure recorded in the distending balloon, but not its volume or weight. Pressure values recorded at each sensation level were constant during repeated determinations of rectal sensation, the volume of rectal distension increased, probably because the rectum had already been dilatated by previous testing. Balloon distension using air with the patient in the lateral position were found to be most practical for routine evaluation of rectal sensation. It is therefore concluded that any disturbance of rectal sensation will be reflected by changes in pressure and not by changes in the volume needed to produce a given sensation level. The location of the receptors involved has to be elucidated, but it seems that the pelvic floor can be excluded since the weight of the rectal contents was not related to sensation.

Résumé

Afin de déterminer quel est le facteur déclenchant principal de la perception rectale, les valeurs respectives du volume, du poids ou de la pression rectale ont été mesurées à chacun des seuils de perception de remplissage rectale (première perception, perception constante, besoin impérieux, maximum tolérable) chez 12 sujets témoins adultes. Le sujet étant en position assise, un ballon rectal est rempli à la vitesse de 60 ml/min avec successivement de l'eau (deux fois) de l'air et du mercure. Les valeurs de pression ont été corrigées en fonction des propriétés élastiques du ballon alors que les volumes d'air insufflés ont été recalculés afin de tenir compte de la pression rectale prévalente et de la température. Les résultats obtenus avec de l'eau, de l'air et du mercure montrent une corrélation constante entre un seuil de perception donné et la pression dans le ballonnet mais ne montrent pas de corrélation avec le volume ou le poids. Les pressions mesurées pour chaque seuil de perception sont constantes lors de déterminations itératives des seuils de perception; le volume de distension rectale augmente probablement parce que le rectum a déjà été dilaté par les mesures précédentes. La distension d'un ballonnet intrarectal avec de l'air sur un sujet en décubitus latéral s'est révèlée être la méthode la plus pratique pour l'évaluation de routine de la perception rectale. En conclusion, toute altération de la perception rectale se traduit par des modifications de la pression et non pas du volume nécessaire pour déclencher une sensation donnée. Le siège exact des récepteurs concernés doit être encore identifié mais il ne semble pas être dans le plancher pelvien car le poids du contenu rectal n'est pas corrélé avec la perception.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Karulf RE, Coller JA, Bartolo DCC, Bowden DO, Roberts PL, Murray JJ, Schoetz DJ Jr, Veidenheimer MC (1991) Anorectal physiology testing. A survey of availability and use. Dis Colon Rectum 34:464–468

    Google Scholar 

  2. Ihre T, (1974) Studies on anal function in continent and incontinent patients. Scan J Gastroenterol 9:1–80

    Google Scholar 

  3. Varma JS, Smith AN, Busuttil A (1985) Correlation of clinical and manometrical abnormalities of rectal function following chronic radiation injury. Br J Surg 72:875–878

    Google Scholar 

  4. Farthing MJG, Lennard-Jones JE (1978) Sensibility of the rectum to distension and the anorectal distension reflex in ulcerative colitis. Gut 19:64–69

    Google Scholar 

  5. Rao SS, Read NW, Davidson PA, Bannister JJ, Holdsworth CD (1987) Anorectal sensitivity and responses to rectal distension in patients with ulcerative colitis. Gastroenterology 93:1270–1275

    Google Scholar 

  6. Loening-Baucke V, Metcalf AM, Shirazi S (1989) Anorectal manometry in active and quiescent ulcerative colitis. Am J Gastroenterol 84:892–897

    Google Scholar 

  7. Rasmussen O, Christensen J, Sørensen M, Tetzschner T, Christiansen J (1990) Rectal compliance in the assessment of patients with faecal incontinence. Dis Colon Rectum 33:650–653

    Google Scholar 

  8. Rasmussen OØ, Sørensen M, Tetzschner T, Christiansen J (1992) Anorectal pressure gradient in patients with anal incontinence. Dis Colon Rectum 35:8–11

    Google Scholar 

  9. Roe AM, Bartolo DCC, Mortensen NJMcC (1986) Diagnosis and surgical management of intractable constipation. Br J Surg 73:854–861

    Google Scholar 

  10. Sørensen M, Tetzschner T, Rasmussen OØ, Christiansen J (1992) Viscous fluid retention: a new method for evaluating anorectal function. Dis Colon Rectum 35:357–361

    Google Scholar 

  11. Waldron D, Bowes KL, Kingma YJ, Cote KR (1988) Colonic and anorectal motility in young women with severe idiopathic constipation. Gastroenterology 95:1388–1394

    Google Scholar 

  12. Verduron A, Devroede G, Bouchoucha M, Arhan P, Schang JC, Poisson J, Hemond M, Hebert M (1988) Megarectum. Dig Dis Sci 33:1164–1174

    Google Scholar 

  13. Johnson GP, Pemberton JH, Ness J, Samson M, Zinsmeister AR (1990) Transducer manometry and the effect of body position on anal canal pressure. Dis Colon Rectum 33:469–475

    Google Scholar 

  14. Penninckx FM, Lestár B, Kerremans RP (1989) A new balloonretaining test for evaluation of anorectal function in incontinent patients. Dis Colon Rectum 32:202–205

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Broens, P.M.A., Penninckx, F.M., Lestár, B. et al. The trigger for rectal filling sensation. Int J Colorect Dis 9, 1–4 (1994). https://doi.org/10.1007/BF00304291

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00304291

Keywords

Navigation