Increased rectal volume is believed to be associated with diminished rectal sensation, i.e., rectal hyposensitivity.
To demonstrate that patients with increased rectal volumes do not automatically have diminished rectal filling sensations.
We, retrospectively, observed 100 adult patients with defecation problems, and 44 healthy controls who had undergone anorectal function tests. Using the balloon retention test, we analyzed the distribution of rectal volumes and pressures at different rectal filling sensation levels.
We found variance in the distribution of rectal volumes at all levels, while rectal pressures showed a normal distribution. We found no correlation between rectal volumes and pressures (constant sensation, r = 0.140, P = 0.163, urge sensation, r = − 0.090, P = 0.375, and maximum tolerable volumes, r = − 0.091, P = 0.366), or when taking age and sex into account. The findings for the patient group were congruent with those for the control group.
Participants with increased rectal volumes do not experience increased rectal pressures at any sensation level. This finding, combined with the knowledge that rectal pressure triggers rectal filling sensation, indicates that rectal filling sensations in patients with increased rectal volumes are not diminished. Therefore, “rectal hyposensitivity” should be reserved for patients with increased rectal pressure thresholds, and not for “abnormally” increased rectal volume thresholds.
Gladman MA, Aziz Q, Scott SM, Williams NS, Lunniss PJ. Rectal hyposensitivity: Pathophysiological mechanisms. Neurogastroenterol Motil. 2009;21:e4–e5. CrossRef
Burgell RE, Scott SM. Rectal hyposensitivity. J. Neurogastroenterol Motil. 2012;18:373–384. CrossRef
Wijffels NA, Angelucci G, Ashrafi A, Jones OM, Cunningham C, Lindsey I. Rectal hyposensitivity is uncommon and unlikely to be the central cause of obstructed defecation in patients with high-grade internal rectal prolapse. Neurogastroenterol Motil. 2011;23:e30. CrossRef
Hammer HF, Phillips SF, Camilleri M, Hanson RB. Rectal tone, distensibility, and perception: Reproducibility and response to different distensions. Am J Physiol. 1998;274:G584–G590. PubMed
Carrington EV, Heinrich H, Knowles CH, et al. Methods of anorectal manometry vary widely in clinical practice: Results from an international survey. Neurogastroenterol Motil. 2017;29: https://doi.org/10.1111/nmo.13016. Epub Jan 18 2017.
- Normal Rectal Filling Sensations in Patients with an Enlarged Rectum
Sanne J. Verkuijl
Paul M. A. Broens
- Springer US
- Digestive Diseases and Sciences
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
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