Abstract
Paradoxical contraction of the puborectalis muscle during simulated defecation straining (anismus) has been cited as a cause of constipation. The functional specificity of this phenomenon was evaluated in 79 patients, 50 with constipation, 21 with idiopathic perineal pain, and eight with solitary rectal ulcer syndrome. Electromyogram evidence of paradoxical puborectalis contraction was observed in 38 (76 percent), ten (48 percent), and four (50 percent) of these patients, respectively. All patients with solitary rectal ulcer syndrome had difficulty defecating; defecation was normal in all patients with perineal pain. These observations suggest that paradoxical contraction of the puborectalis muscle is not a specific finding, and that it is not the sole cause of constipation in patients with anismus.
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This study was supported by the St. Mark's Hospital Research Foundation and the F. H. Muirhead Trust. P. N. Jones was attached to the Sir Alan Parks Physiology Laboratory during an elective period by arrangement with The Medical School of The University of Leeds.
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Jones, P.N., Lubowski, D.Z., Swash, M. et al. Is paradoxical contraction of puborectalis muscle of functional importance?. Dis Colon Rectum 30, 667–670 (1987). https://doi.org/10.1007/BF02561685
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DOI: https://doi.org/10.1007/BF02561685