Abstract
The aim of this study was to develop a method by which rectal and colonic activity could be examined during defaecation under physiological conditions, in order to evaluate whether the colon plays a role in defaecation. Subjects presented to the Nuclear Medicine department on the day following ingestion of oral In-111 labelled DTPA, when they developed the normal urge to defaecate. Defaecation took place in a private room while dynamic scintigraphy of the rectum and colon was recorded. Fourteen subjects were studied (8 normal subjects, 4 with constipation, 2 with irritable bowel syndrome). In 13 subjects the left colon was visualized during defaecation and emptying was clearly observed in 12. The right colon was visualised in 11 subjects and emptying was seen in 7. Mean percentage segmental evacuation was right colon 20%, left colon 32% and rectum 66%. Colonic emptying occurs during defaecation, which is not a process of rectal evacuation only. This has implications for the understanding of the pathophysiology of obstructed defaecation.
Résumé
Le but de cette étude était de développer une méthode permettant d'examiner l'activité rectale et colique au cours de la défécation dans des conditions phygiologiques afin de déterminer le rôle que joue le côlon dans la défécation. Les sujets se présentent au département de médicine nucléaire le lendemain de l'ingestion orale de DTPA marqués à l'In-111, lorsqu'ils ressentent le besoin urgent d'exonérer. La défécation est réalisée dans un local privé alors même que l'on enregistre la scintigraphie dynamique du côlon et du rectum. Quatorze patients ont été étudiés (8 sujets normaux, 4 avec constipation et 2 avec un syndrome du côlon irritable). Chez 13 des patients, le côlon gauche a été visualisé durant la défécation et l'évacuation a été clairement observée chez 12 patients. Le côlon droit a été visualisé chez 11 patients et l'évacuation chez 7. L'activité d'évacuation segmentaire moyenne du côlon droit est de 20%, du côlon gauche de 32% et du rectum de 66%. L'évacuation du contenu colique survient au cours de la défécation qui n'est ainsi pas qu'un processus d'évacuation rectale. Cette constatation a des implications quant à la compréhension de la pathophysiologie des dyschézies.
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References
Hinton J, Lennard-Jones JE, Young A (1969) A new method of studying gut transit times using radio opaque markers. Gut 10:842–847
Smart RC, McLean RG, Gaston-Parry D, Barbagallo S, Bruck CE, King DW, Lubowski DZ, Talley NA (1991) Comparison of oral I-131 cellulose and In-111 DTPA as tracers for colon transit scintigraphy-analysis by colon activity profiles. J Nucl Med 32:1668–1674
Finlay IG (ed) (1988) Proctography: Symposium. International J Colorect Dis 3:67–89
Kuijpers HC, Bleijenberg G (1985) The spastic pelvic floor syndrome. Dis Colon Rectum 28:669–672
Editorial (1992) Anismus and biofeedback. Lancet 339(i):217–218
Jones PN, Lubowski DZ, Swash M, Henry MM (1987) Is paradoxical contraction of puborectalis muscle of functional importance? Dis Colon Rectum 30:667–670
Lubowski DZ, King DW, Finlay IG (1992) Electromyography of the pubococcygeus muscles in patients with obstructed defaecation. International J Colorect Dis 7:184–187
McLean RG, Smart RC, Gaston-Perry D, Barbagallo S, Baker J, Lyons NR, Bruck CE, King DW, Lubowski DZ, Talley NA (1990) Colon transit scintigraphy in health and constipation using oral I-131 cellulose. J Nucl Med 31:985–989
Narducci F, Bassotti G, Gaburri M, Morelli A (1987) Twenty four hour manometric recording of colonic motor activity in healthy man. Gut 28:17–25
Kamm MA, Van Der Sijp J, Lennard-Jones JE (1992) Colorectal and anal motility during defaecation. Lancet 339(i):820
Halls J (1965) Bowel content shift during normal defaecation. Proc Roy Soc Med 58:859–860
Preston DM, Lennard-Jones J (1985) Anismus in chronic constipation. Dig Dis Sci 30:413–418
Kuijpers HC, Strijk SP (1984) Diagnosis of disturbances of continence and defaccation. Dis Colon Rectum 27:658–662
Womack NR, Williams NS, Holmfield JH, Morrison JFB, Simpkins KC (1985) New method for the dynamic assessment of anorectal function in constipation. Br J Surg 72:994–998
Barnes PRH, Lennard-Jones J (1988) Function of the striated anal sphincter during straining in control subjects and constipated patients with a radiologically normal rectum or idiopathic megacolon. Int J Colorect Dis 3:207–209
Ambrose WL, Pemberton JH, Litchy WJ, Hanson RB (1990) The myoelectric activity of the pubococcygeus muscle. Dis Colon Rectum 33:A29
Duthie GS, Bartolo DCC, Miller R (1991) Estimation of the incidence of anismus by laboratory tests. Br J Surg 78:747
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Lubowski, D.Z., Meagher, A.P., Smart, R.C. et al. Scintigraphic assessment of colonic function during defaecation. Int J Colorect Dis 10, 91–93 (1995). https://doi.org/10.1007/BF00341204
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DOI: https://doi.org/10.1007/BF00341204