| Autor: |
William A. Bauman, Reagan Mendoza, Robert Paulino, Erdal Cavusoglu, Anthony J. Ng, Graham H. Creasey, Roberta Modeste-Duncan, Alan S. Rosman, Grace Lirio, Jill M. Wecht, Mark A. Korsten |
| Rok vydání: |
2003 |
| Předmět: |
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| Zdroj: |
Gastroenterology. 124:A115 |
| ISSN: |
0016-5085 |
| DOI: |
10.1016/s0016-5085(03)80564-4 |
| Popis: |
Passage of flatus is a normal event, but little is known about anorectal pressure patterns that underlie its occurrence. Functional bowel patients may report excess flatus and gasrelated pain. We aimed to quantify rectal pressure increases and anal relaxations occurring during gas passage and abdominal pain. 10 healthy subjects underwent jejunal perfusion of a physiologic gas mixture (88% N~, 5.5% 05, 6.5% CO2) at 12 ml/mm for 2.5 hours. Rectal and anal pressures were recorded using manometry catheters with multiple sideholes and Dent sleeves. Gas passages and abdominal pain reported by subjects were correlated with anorectal pressure events. Prior to jejunal gas perfusion, rectal and anal pressures were 24.1 + 4.8 and 103.0 + 10.9 mmHg. Beginning 22 + 7 rain after starting gas perfusion, intermittent rectal pressure increases associated with anal relaxations were seen. In the last 30 min of testing, rectal pressure increases occurred in pulsatile fashion at 0.9+-0.1 times per min with mean durations of 15.7_ + 1.4 sec and peak pressures of 62.6_+ 1.2 mmHg. Anal relaxations occurred concurrently with rectal pulses. 50% of rectal pulses were associated with gas passages when rectal and anal pressures equilibrated. The critical rectal pressure for gas expulsion was 45.6+-8.4 mmHg, which was similar to anal relaxations (45.0_+8.8 mm Hg). 43% of rectal pulses were associated with crampy pain, usually in the lower abdomen. All pain episodes were associated with rectal pulses and resolved with gas passage or return of rectal pressure to baseline. Rectal pulses with and without pain were of similar amplitude. In conclusion, flatus passage during jejunal gas perfusion occurs due to rectal pressure pulses with simultaneous anal relaxations with equilibration of rectal and anal pressures. Rectal pressure pulses also elicit lower abdominal pain which is relieved by anal gas passage. These findings may provide insight into symptom pathophyslology in patients with excess flatus and gas-induced abdominal pain. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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