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Anorectal Function

  • Marinko Marušić
  • Rosana Troskot Perić
  • Antonio Klemenčić
Chapter
Part of the Clinical Gastroenterology book series (CG)

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.

Keywords

Diabetes mellitus Colon Anorectal function Assessment of colonic and anorectal function Enteric nervous system Interstitial cells of Cajal 

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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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Marinko Marušić
    • 1
    • 2
    • 3
  • Rosana Troskot Perić
    • 1
    • 2
    • 3
  • Antonio Klemenčić
    • 4
  1. 1.Department of Hepatology and GastroenterologyUniversity Hospital Sveti DuhZagrebCroatia
  2. 2.Medical SchoolJ.J. Strossmayer University of OsijekOsijekCroatia
  3. 3.Faculty of Health StudiesUniversity of RijekaRijekaCroatia
  4. 4.Educational Institute for Emergency Medicine of the City of ZagrebZagrebCroatia

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