Functional Anorectal Disorders.

Abstract:

:This report defines criteria and reviews the epidemiology, pathophysiology, and management of common anorectal disorders: fecal incontinence (FI), functional anorectal pain and functional defecation disorders. FI is defined as the recurrent uncontrolled passage of fecal material for at least 3 months. The clinical features of FI are useful for guiding diagnostic testing and therapy. Anorectal manometry and imaging are useful for evaluating anal and pelvic floor structure and function. Education, antidiarrheals and biofeedback therapy are the mainstay of management; surgery may be useful in refractory cases. Functional anorectal pain syndromes are defined by clinical features and categorized into three subtypes. In proctalgia fugax, the pain is typically fleeting and lasts for seconds to minutes. In levator ani syndrome (LAS) and unspecified anorectal pain the pain lasts more than 30 minutes, but in LAS there is puborectalis tenderness. Functional defecation disorders are defined by >2 symptoms of chronic constipation or irritable bowel syndrome with constipation, and with >2 features of impaired evacuation i.e., abnormal evacuation pattern on manometry, abnormal balloon expulsion test or impaired rectal evacuation by imaging. It includes two subtypes; dyssynergic defecation and inadequate defecatory propulsion. Pelvic floor biofeedback therapy is effective for treating LAS and defecatory disorders.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Rao SS,Bharucha AE,Chiarioni G,Felt-Bersma R,Knowles C,Malcolm A,Wald A

doi

10.1053/j.gastro.2016.02.009

subject

Has Abstract

pub_date

2016-03-25 00:00:00

eissn

0016-5085

issn

1528-0012

pii

S0016-5085(16)00175-X

pub_type

杂志文章
  • Effect of 15(R)-15-methyl prostaglandin E2 (arbaprostil) on the healing of duodenal ulcer: a double-blind multicenter study.

    abstract::A multicenter study was conducted on 173 patients with active, endoscopically proven duodenal ulcers (158 men, 15 women). They were randomly assigned, in a double-blind manner, to two groups: those receiving placebo capsules (91 patients) and those receiving capsules containing 100 microgram of 15(R)-15-methyl prostag...

    journal_title:Gastroenterology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Vantrappen G,Janssens J,Popiela T,Kulig J,Tytgat GN,Huibregtse K,Lambert R,Pauchard JP,Robert A

    更新日期:1982-08-01 00:00:00

  • Internal anal sphincter in neurogenic fecal incontinence.

    abstract::In neurogenic fecal incontinence there is denervation of the external anal sphincter and pelvic floor muscles but the role of the internal anal sphincter is incompletely understood. We have evaluated the internal anal sphincter in 6 patients with neurogenic incontinence undergoing postanal repair and in 7 control subj...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(88)90175-8

    authors: Lubowski DZ,Nicholls RJ,Burleigh DE,Swash M

    更新日期:1988-10-01 00:00:00

  • Hepatocyte tight-junctional permeability is increased in rat experimental colitis.

    abstract:BACKGROUND & AIMS:Hepatobiliary complications occur in inflammatory bowel disease and may be caused by the translocation of intestinal toxins from portal blood into bile through leaky hepatocyte tight junctions. The role of tight junctions in the pathogenesis of hepatobiliary complications in experimental inflammatory ...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1053/gast.1997.v113.pm9322530

    authors: Lora L,Mazzon E,Martines D,Fries W,Muraca M,Martin A,d'Odorico A,Naccarato R,Citi S

    更新日期:1997-10-01 00:00:00

  • The homeodomain protein Cdx2 regulates lactase gene promoter activity during enterocyte differentiation.

    abstract:BACKGROUND & AIMS:Lactase is the intestinal disaccharidase responsible for digestion of lactose, the predominant carbohydrate in milk. Transcription of the lactase gene is activated during enterocyte differentiation. We have characterized the interaction between the lactase promoter and Cdx2, a homeodomain protein invo...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/s0016-5085(00)70420-3

    authors: Fang R,Santiago NA,Olds LC,Sibley E

    更新日期:2000-01-01 00:00:00

  • Gliadin immune reactivity is associated with overt and latent enteropathy in relatives of celiac patients.

    abstract::Antigliadin antibodies have been widely used in the screening of celiac disease. Using this test, candidates for jejunal biopsy were selected from 328 first-degree relatives of 128 adult celiac patients. All relatives geographically available were willing to participate in the study. Twenty-one turned out to be positi...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(92)91172-z

    authors: Corazza G,Valentini RA,Frisoni M,Volta U,Corrao G,Bianchi FB,Gasbarrini G

    更新日期:1992-11-01 00:00:00

  • Entecavir therapy for up to 96 weeks in patients with HBeAg-positive chronic hepatitis B.

    abstract:BACKGROUND & AIMS:Entecavir demonstrated superior benefit to lamivudine at 48 weeks in nucleoside-naive patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB). We evaluated continued entecavir and lamivudine treatment through 96 weeks. METHODS:709 HBeAg-positive CHB patients were randomized to ...

    journal_title:Gastroenterology

    pub_type: 杂志文章,随机对照试验

    doi:10.1053/j.gastro.2007.08.025

    authors: Gish RG,Lok AS,Chang TT,de Man RA,Gadano A,Sollano J,Han KH,Chao YC,Lee SD,Harris M,Yang J,Colonno R,Brett-Smith H

    更新日期:2007-11-01 00:00:00

  • Family studies of lactase deficiency in the American Indian.

    abstract::To determine the pattern of inheritance of lactase deficiency, we studied 104 American Indian and 2 white subjects in 19 families. Subjects were considered deficient in lactase if breath-hydrogen excretion exceeded 0.20 ml per min above fasting at 2 hr after a lactose load of 2 g per kg of body weight (maximum 50 g). ...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:

    authors: Newcomer AD,Gordon H,Thomas PJ,McGill DB

    更新日期:1977-11-01 00:00:00

  • Effects of test meal, intragastric nutrients, and intraduodenal bile on plasma concentrations of immunoreactive somatostatin and vasoactive intestinal peptide in dogs.

    abstract::Specific radioimmunoassay were used to measure somatostatin and vasoactive peptide in portal and peripheral plasma from conscious dogs prepared with indwelling portal catheters. In six animals with intact stomachs, a test meal induced a significant rise of portal and peripheral somatostatin, while the significant resp...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:

    authors: Chayvialle JA,Miyata M,Rayford PL,Thompson JC

    更新日期:1980-11-01 00:00:00

  • Cytomegalovirus infection of the appendix in patient with the acquired immunodeficiency syndrome.

    abstract::Disseminated cytomegalovirus infection occurs predominantly in immunocompromised hosts. Involvement of the gastrointestinal tract in the acquired immunodeficiency syndrome is frequent, but to our knowledge there is only one report of involvement of the appendix. In this study, a patient with a history of the acquired ...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(91)90485-4

    authors: Valerdiz-Casasola S,Pardo-Mindan FJ

    更新日期:1991-07-01 00:00:00

  • h-sgk serine-threonine protein kinase gene as transcriptional target of transforming growth factor beta in human intestine.

    abstract:BACKGROUND & AIMS:Recently, the immediate early gene h-sgk was cloned as a hypertonicity-induced gene from human hepatoma cells. The aim of this study was to localize h-sgk messenger RNA (mRNA) expression in normal and inflamed intestinal mucosa and to identify potential transcriptional regulators. METHODS:h-sgk mRNA ...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/s0016-5085(99)70011-9

    authors: Waldegger S,Klingel K,Barth P,Sauter M,Rfer ML,Kandolf R,Lang F

    更新日期:1999-05-01 00:00:00

  • Evidence of central and peripheral sensitization in a rat model of narcotic bowel-like syndrome.

    abstract:BACKGROUND & AIMS:Narcotic bowel syndrome (NBS) is a subset of opioid bowel dysfunctions that results from prolonged treatment with narcotics and is characterized by chronic abdominal pain. NBS is under-recognized and its molecular mechanisms are unknown. We aimed to (1) develop a rat model of NBS and (2) to investigat...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1053/j.gastro.2010.03.046

    authors: Agostini S,Eutamene H,Cartier C,Broccardo M,Improta G,Houdeau E,Petrella C,Ferrier L,Theodorou V,Bueno L

    更新日期:2010-08-01 00:00:00

  • Ultrastructural immunocytochemical localization of the asialoglycoprotein receptor in rat hepatocytes.

    abstract::The asialoglycoprotein receptor is present on the plasma membrane of rat hepatocytes and mediates the endocytosis of exogenous asialoglycoproteins. The intracellular locations of the receptor are incompletely defined, and whether the receptor is present on the canalicular membrane is controversial. To investigate thes...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:

    authors: Mizuno M,Brown WR,Vierling JM

    更新日期:1984-10-01 00:00:00

  • Evidence for autoregulation of cholecystokinin secretion during diversion of bile pancreatic juice in rats.

    abstract:BACKGROUND & AIMS:The mechanism regulating cholecystokinin (CCK) secretion during prolonged diversion of bile pancreatic juice (BPJ) is unknown. We examined the hypothesis that the decrease of plasma CCK levels after prolonged diversion of BPJ is mediated by an increase in plasma somatostatin levels evoked by hyperchol...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(95)90289-9

    authors: Li Y,Hao Y,Owyang C

    更新日期:1995-07-01 00:00:00

  • T-helper 17 and interleukin-17-producing lymphoid tissue inducer-like cells make different contributions to colitis in mice.

    abstract:BACKGROUND & AIMS:T helper (Th) 17 cells that express the retinoid-related orphan receptor (ROR) γt contribute to the development of colitis in mice, yet are found in normal and inflamed intestine. We investigated their development and functions in intestines of mice. METHODS:We analyzed intestinal Th17 cells in healt...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1053/j.gastro.2012.07.108

    authors: Ono Y,Kanai T,Sujino T,Nemoto Y,Kanai Y,Mikami Y,Hayashi A,Matsumoto A,Takaishi H,Ogata H,Matsuoka K,Hisamatsu T,Watanabe M,Hibi T

    更新日期:2012-11-01 00:00:00

  • Enterohepatic circulation of bacterial chemotactic peptide in rats with experimental colitis.

    abstract::The association of hepatobiliary disorders with colonic inflammation is well recognized. Although the pathophysiology is obscure, increased permeation of toxic bacterial products across the inflamed gut to the portal circulation might be one mechanism. Potentially toxic metabolites include N-formylated chemotactic pep...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(88)90560-4

    authors: Hobson CH,Butt TJ,Ferry DM,Hunter J,Chadwick VS,Broom MF

    更新日期:1988-04-01 00:00:00

  • The genesis of bowel sounds: influence of viscus and gastrointestinal content.

    abstract::This study was undertaken to try to solve the controversy about the influence of gastrointestinal contents on the genesis of bowel sounds, and to probe the respective importance of the various abdominal viscera. Eleven healthy volunteers were intubated by mouth with a multiple-lumen tube. Bowel sounds were recorded fo...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:

    authors: Politzer JP,Devroede G,Vasseur C,Gerard J,Thibault R

    更新日期:1976-08-01 00:00:00

  • Cell wall-defective variants of pseudomonas-like (group Va) bacteria in Crohn's disease.

    abstract::Several animal transmission studies have indicated that Crohn's disease may be caused by a filterable agent. Filtrates of homogenized tissues were prepared from 8 patients with Crohn's disease, 9 patients with chronic ulcerative colitis, and 20 control patients without inflammatory bowel disease. Conventional bacterio...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:

    authors: Parent K,Mitchell P

    更新日期:1978-09-01 00:00:00

  • Involvement of tumor necrosis factor-alpha in the pathogenesis of activated macrophage-mediated hepatitis in mice.

    abstract::The possible involvement of tumor necrosis factor-alpha in the pathogenesis of an experimentally induced hepatitis was investigated. Balb/c mice were primed with Propionibacterium acnes to induce the infiltration of mononuclear cells into the liver. Immunohistochemical study showed that most of the accumulated mononuc...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(90)90965-4

    authors: Nagakawa J,Hishinuma I,Hirota K,Miyamoto K,Yamanaka T,Tsukidate K,Katayama K,Yamatsu I

    更新日期:1990-09-01 00:00:00

  • Analysis of pulmonary heme oxygenase-1 and nitric oxide synthase alterations in experimental hepatopulmonary syndrome.

    abstract:BACKGROUND & AIMS:Cirrhosis and portal hypertension due to chronic common bile duct ligation reproduce the features of human hepatopulmonary syndrome, whereas portal hypertension alone due to partial portal vein ligation does not. Nitric oxide contributes to experimental hepatopulmonary syndrome, but the nitric oxide s...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/j.gastro.2003.07.005

    authors: Zhang J,Ling Y,Luo B,Tang L,Ryter SW,Stockard CR,Grizzle WE,Fallon MB

    更新日期:2003-11-01 00:00:00

  • Quantitative aspects of portal-systemic and arteriovenous shunts within the liver in cirrhosis.

    abstract::To estimate vascular changes in chronic liver disease, we quantitated intrahepatic arteriovenous and portal-systemic shunts in 12 patients with cirrhosis and arteriovenous shunts alone in 4 patients with cirrhosis. An index was obtained for intrahepatic arteriovenous shunts by instilling technetium 99m-macroaggregated...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(87)90324-6

    authors: Ohnishi K,Chin N,Sugita S,Saito M,Tanaka H,Terabayashi H,Saito M,Iida S,Nomura F,Okuda K

    更新日期:1987-07-01 00:00:00

  • Effects of arginine vasopressin on capillary filtration in the cat ileum.

    abstract::The effect of local intraarterial infusion of arginine vasopressin was studied in a vascularly perfused segment of cat ileum. Systemic arterial pressure (Pa), superior mesenteric arterial pressure (Pma), superior mesenteric venous pressure (Pv), blood flow (QB) and intestinal volume (V) were continuously monitored. In...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:

    authors: Quillen EW,Granger DN,Taylor AE

    更新日期:1977-12-01 00:00:00

  • Gastrointestinal transit time in human pregnancy: prolongation in the second and third trimesters followed by postpartum normalization.

    abstract::Fifty-nine studies of gastrointestinal transit time were performed in 27 healthy women during pregnancy and postpartum. Gastrointestinal transit time was defined as the time of the first sustained rise in breath hydrogen concentration after ingestion of 10 g of lactulose. Gastrointestinal transit time was significantl...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(85)90199-4

    authors: Lawson M,Kern F Jr,Everson GT

    更新日期:1985-11-01 00:00:00

  • Effect of gluten supplementation in healthy siblings of children with celiac disease.

    abstract::The clinical, functional, and histopathological effects of 18 g additional gluten intake daily for 4 wk was studied in 13 healthy siblings of Spanish children with celiac disease, including two pairs of discordant monozygotic twins. Five of the 13 children were HLA-DR identical to the celiac sibling, 5 shared only one...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(87)90017-5

    authors: Polanco I,Mearin ML,Larrauri J,Biemond I,Wipkink-Bakker A,Peña AS

    更新日期:1987-03-01 00:00:00

  • Impairment of aminopyrine clearance in aspirin-damaged canine gastric mucosa.

    abstract::Using an in vivo canine chambered stomach preparation, the clearance of [14C]aminopyrine across mucosa when intravenously infused and the back-diffusion of this substance from gastric lumen to mucosa when topically applied to gastric epithelium were evaluated in aspirin-damaged gastric epithelium. In mucosa damaged by...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:

    authors: Miller TA,Henagan JM,Loy TM

    更新日期:1983-09-01 00:00:00

  • Differentiation of gastric ECL cells is altered in CCK(2) receptor-deficient mice.

    abstract:BACKGROUND & AIMS:Gastrin stimulation of the type 2 cholecystokinin (CCK(2)) receptor results in ECL cell proliferation and histamine secretion. This report describes the effects of targeted disruption of the CCK(2) receptor gene on ECL cell morphology and function. METHODS:The ECL cells in the oxyntic mucosa of CCK(2...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1053/gast.2002.34746

    authors: Chen D,Zhao CM,Al-Haider W,Håkanson R,Rehfeld JF,Kopin AS

    更新日期:2002-08-01 00:00:00

  • Inactivation of rat small intestinal brush-border membrane alkaline phosphatase by oxygen free radicals.

    abstract:BACKGROUND:To date, the potential effects of free radicals on the activities of intestinal brush-border membrane enzymes have received little attention. Therefore, we conducted a series of experiments to examine the effects of free radicals on various enzymatic activities of rat small intestinal brush-border membranes....

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(93)90708-k

    authors: Dudeja PK,Brasitus TA

    更新日期:1993-08-01 00:00:00

  • Peptostreptococcus anaerobius Induces Intracellular Cholesterol Biosynthesis in Colon Cells to Induce Proliferation and Causes Dysplasia in Mice.

    abstract:BACKGROUND & AIMS:Stool samples from patients with colorectal cancer (CRC) have a higher abundance of Peptostreptococcus anaerobius than stool from individuals without CRC, based on metagenome sequencing. We investigated whether P anaerobius contributes to colon tumor formation in mice and its possible mechanisms of ca...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1053/j.gastro.2017.01.009

    authors: Tsoi H,Chu ESH,Zhang X,Sheng J,Nakatsu G,Ng SC,Chan AWH,Chan FKL,Sung JJY,Yu J

    更新日期:2017-05-01 00:00:00

  • Cholecystokinin release from isolated canine epithelial cells in short-term culture.

    abstract::Canine jejunal epithelial cells were isolated and maintained in short-term culture to study cholecystokinin (CCK) release. Sequential digestion of jejunal mucosa with collagenase and ethylenediaminetetraacetic acid was followed by counterflow elutriation to enrich CCK-containing cells. After 40 hours in culture on col...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1016/0016-5085(92)91780-8

    authors: Koop I,Buchan AM

    更新日期:1992-01-01 00:00:00

  • Intraarterial vasopressin in the treatment of upper gastrointestinal hemorrhage: a prospective, controlled clinical trial.

    abstract::Intraarterial vasopressin has been reported to be effective in the treatment of massive upper gastrointestinal hemorrhage. A prospective, controlled clinical trial comparing conventional treatment with conventional therapy plus intraarterial vasopressin was undertaken. Sixty episodes of upper gastrointestinal hemorrha...

    journal_title:Gastroenterology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Conn HO,Ramsby GR,Storer EH,Mutchnick MG,Joshi PH,Phillips MM,Cohen GA,Fields GN,Petroski D

    更新日期:1975-02-01 00:00:00

  • Loss of SMAD4 alters BMP signaling to promote colorectal cancer cell metastasis via activation of Rho and ROCK.

    abstract:BACKGROUND & AIMS:SMAD4 frequently is lost from colorectal cancers (CRCs), which is associated with the development of metastases and a poor prognosis. SMAD4 loss is believed to alter transforming growth factor β signaling to promote tumor progression. However, SMAD4 is also a central component of the bone morphogeneti...

    journal_title:Gastroenterology

    pub_type: 杂志文章

    doi:10.1053/j.gastro.2014.03.052

    authors: Voorneveld PW,Kodach LL,Jacobs RJ,Liv N,Zonnevylle AC,Hoogenboom JP,Biemond I,Verspaget HW,Hommes DW,de Rooij K,van Noesel CJ,Morreau H,van Wezel T,Offerhaus GJ,van den Brink GR,Peppelenbosch MP,Ten Dijke P,Hardwick JC

    更新日期:2014-07-01 00:00:00