Abstract
To obtain clear evidence of the rectoanal reflex, cold water was injected into the rectum. All patients with a normal reflex had a rectoanal reflex when the water was either 4°C or 17°C. The same reflex was seen when a balloon was used for distention. No reflex was evident when the water was 37°C. At 27°C or 45°C, the reflex was evident occasionally. In patients with Hirschsprung's disease, the rectoanal reflex was absent with balloon distention, and when water at any temperature was injected. As cold water will induced the rectoanal reflex safely and without rectal distention, measurement of the reflex using cold water is useful when the presence or absence of the reflex is doubtful. The authors' results suggest that the receptor related to the reflex is neuronal in origin and not muscular, and that the receptor locates near the mucosa.
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References
Gowers WR, Sanderson JSB. The automatic action of the sphincter ani. Proc R Soc London 1877;26:77–84.
Gaston EA. The physiology of fecal continence. Surg Gynecol Obstet 1948;87:280–290.
Schnaufer L, Talbert JL, Haller JA, Reid NC, Tobon F, Schuster MM. Differential sphincteric studies in the diagnosis of anorectal disorders of childhood. J Pediatr Surg 1967;2:538–43.
Lawson JO, Nixon HH. Anal canal pressure in the diagnosis of Hirschsprung's disease. J Pediatr Surg 1967;2:544–52.
Nagasaki A, Ikeda K, Suita S, Hayashida Y, Goto S, Sumitomo K. Analysis of children with Hirschsprung's disease with a decrease in anal canal pressure. J Jap Soc Coloproctol 1982;35:147–52.
Meunier P, Marechal JM, Mollad P. Accuracy of the manometric diagnosis of Hirschsprung's disease. J Pediatr Surg 1978;13:411–5.
Nagasaki A, Ikeda K, Suita S, Sumitomo K. Induction of the rectoanal reflex by electric stimulation: a diagnostic aid for Hirschsprung's disease. Dis Colon Rectum 1984;27:598–601.
Suzuki H, Kuriyama H. Electrical and mechanical properties of longitudinal and circular muscle of the guinea-pig ileum. Jap J Physiol 1975;25:759–73.
Watanabe K. The effect of the intrinsic mucosal reflex upon the mobility of internal anal sphincter. Jap J Smooth Muscle Res 1973;9:99–108.
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Nagasaki, A., Ikeda, K. & Sumitomo, K. Rectoanal reflex induced by H2O thermal stimulation. Dis Colon Rectum 32, 765–768 (1989). https://doi.org/10.1007/BF02562125
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DOI: https://doi.org/10.1007/BF02562125