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Anorectal Function

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Gastrointestinal Complications of Diabetes

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

The integrated performance of colon, rectum with anal canal, pelvic floor muscles, and neural pathways play an essential role in the normal function of the lower gastrointestinal system. Diabetes mellitus can lead to the impairment of the entire gastrointestinal system, including colon and anorectum as its terminal parts. Diabetes-related impairment of this region of the gastrointestinal tract can cause disturbances which can markedly reduce the quality of life of the affected patients. To objectify the influence of diabetes on this region, there are a number of methods that aim to assess the function of the colon and anorectal function. However, understanding the diabetes-driven changes in the lower part of the gastrointestinal system is a challenge due to the diverse underlying mechanisms that control the gut homeostasis, and considering that in-vivo investigation in humans is not really feasible. Nevertheless, there is a growing amount of knowledge with regard to the effect of diabetes on functions of both colon and anorectum. This chapter provides an overview of functional anatomy, physiology, and the assessment of colonic and anorectal function, as well as the effect of diabetes on the terminal part of the gastrointestinal system.

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Abbreviations

AGE:

Advanced glycation end products

CTT:

Colonic transit time

EAS:

External anal sphincter

EMG:

Electromyography

ENS:

Enteric nervous system

GSH:

Reduced glutathione

IAS:

Internal anal sphincter

ICC:

Interstitial cells of Cajal

NANC:

Non-adrenergic non-cholinergic pathway

NO:

Nitric oxide

NO synthase:

Nitric oxide synthase

PNTML test:

Pudendal nerve terminal motor latency test

RACR:

Rectoanal contractile reflex

RAIR:

Rectoanal inhibitory reflex

ROM:

Radiopaque markers

SMR:

Sensorimotor response

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Authors and Affiliations

  1. Department of Hepatology and Gastroenterology, University Hospital Sveti Duh, Zagreb, Croatia

    Marinko Marušić & Rosana Troskot Perić

  2. Medical School, J.J. Strossmayer University of Osijek, Osijek, Croatia

    Marinko Marušić & Rosana Troskot Perić

  3. Faculty of Health Studies, University of Rijeka, Rijeka, Croatia

    Marinko Marušić & Rosana Troskot Perić

  4. Educational Institute for Emergency Medicine of the City of Zagreb, Zagreb, Croatia

    Antonio Klemenčić

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  1. Marinko Marušić
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  3. Antonio Klemenčić
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Correspondence to Marinko Marušić .

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  1. Sestre milosrdnice University Hospital Center, University of Zagreb School of Medicine, Zagreb, Croatia

    Marko Duvnjak

  2. Merkur University Hospital, University of Zagreb School of Medicine, Zagreb, Croatia

    Lea Smirčić-Duvnjak

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Marušić, M., Perić, R.T., Klemenčić, A. (2018). Anorectal Function. In: Duvnjak, M., Smirčić-Duvnjak, L. (eds) Gastrointestinal Complications of Diabetes . Clinical Gastroenterology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-75856-5_12

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