Anorectal Physiology in Health and with Inflammation

The complex physiology of the anorectum is adversely influenced by inflammation with increased sensitivity to sensation and an amplification of muscular responses stimulated by stool in the rectum. Tenesmus is the sensation of incomplete evacuation of the rectum or nonproductive straining to defecate. It occurs when rectal contraction is accompanied by internal anal sphincter relaxation. In the presence of inflammation, there is sensitivity to lower than normal volumes of balloon distention and exaggerated relaxation of the internal anal sphincter (IAS). The sensations accompanying this response are perceived rectal fullness, urgency to defecate and a sense of incomplete evacuation. Occasionally, tenesmus continues when visible inflammation is no longer present. When this occurs, treatment for microscopic inflammation or pharmacologic manipulation of rectal contractility and IAS relaxation improves these symptoms. In addition to the influence of rectal inflammation on anorectal physiology, left-sided colitis changes the physiology of the normal appearing proximal colon. This was recognized as early as 1964 when Lennard-Jones described proximal constipation in patients with left-sided UC. Recent studies demonstrate inhibition of stool movement proximal to the line of demarcation of disease. The changes in motility have important implications for topical rectal therapy.

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Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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