{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T08:27:11Z","timestamp":1773304031867,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T00:00:00Z","timestamp":1496707200000},"content-version":"vor","delay-in-days":66,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Fecal incontinence (FI) and constipation can arise from a variety of alterations of anorectal function. This study aimed to investigate the components of the anorecal reflex in patients with these symptoms and to determine the functional significance of various physiological parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Altogether 21 healthy volunteers (controls) and 78 FI\u2010predominant and 74 constipation\u2010predominant patients were recruited and administered <jats:styled-content style=\"fixed-case\">W<\/jats:styled-content>exner incontinence and constipation questionnaires. All participants underwent standardized anorectal physiology assessments.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Patients with passive FI had lower resting sphincter pressures than controls (38 cmH<jats:sub>2<\/jats:sub>O <jats:italic>vs<\/jats:italic> 87\u2009cmH<jats:sub>2<\/jats:sub>O, <jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content>\u2009<jats:italic>&lt;<\/jats:italic>\u20090.05), while those with urge FI had lower squeeze pressures than controls (37 cmH<jats:sub>2<\/jats:sub>O <jats:italic>vs<\/jats:italic> 119 cmH<jats:sub>2<\/jats:sub>O, <jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content>\u2009<jats:italic>&lt;<\/jats:italic>\u20090.05). Patients with urge FI had lower maximal tolerable volumes (100 mL <jats:italic>vs<\/jats:italic> 166\u2009mL, <jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content>\u2009<jats:italic>&lt;<\/jats:italic>\u20090.05). Patients with slow\u2010transit constipation had elevated rectal electrosensitivity thresholds compared with controls (31.4 mA <jats:italic>vs<\/jats:italic> 20.2\u2009mA, <jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content>\u2009<jats:italic>&lt;<\/jats:italic>\u20090.05), and rectal mucosal blood flow than patients with evacuation difficulty and controls (107 <jats:italic>vs<\/jats:italic> 162 <jats:styled-content style=\"fixed-case\">flux units (FU)<\/jats:styled-content> [evacuation difficulty] <jats:italic>vs<\/jats:italic> 169 <jats:styled-content style=\"fixed-case\">FU<\/jats:styled-content> [controls], <jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content>\u2009<jats:italic>&lt;<\/jats:italic>\u20090.05). Only patients with passive FI were associated with reflex abnormalities (prolonged recovery phase (1.2 ms <jats:italic>vs<\/jats:italic> 0.5\u2009ms, <jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content>\u2009<jats:italic>&lt;<\/jats:italic>\u20090.05) and total duration of reflex (6.3 ms <jats:italic>vs<\/jats:italic> 4.3\u2009ms, <jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content>\u2009<jats:italic>&lt;<\/jats:italic>\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Anorectal motor, sensory and reflex abnormalities are seen in distinct patterns in patients with FI and constipation. This would suggest distinct physiological differences that may predict the potential for different neuromodulation treatment and behavioral modalities in these conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.12462","type":"journal-article","created":{"date-parts":[[2017,3,6]],"date-time":"2017-03-06T09:56:38Z","timestamp":1488794198000},"page":"222-228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Physiological study of the anorectal reflex in patients with functional anorectal and defecation disorders"],"prefix":"10.1111","volume":"18","author":[{"given":"Kumaran","family":"Thiruppathy","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Royal Berkshire Hospital  Reading UK"},{"name":"Gastrointestinal Physiology Unit, Department of Gastroenterology University College Hospital  London 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