{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T15:04:11Z","timestamp":1792854251757,"version":"4.5.0"},"reference-count":13,"publisher":"BMJ","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1990,9]]},"abstract":"<jats:p>The relation between sensory perception of rapid balloon distension of the rectum and the motor responses of the rectum and external and internal anal sphincters in 27 normal subjects and 16 patients with faecal incontinence who had impaired rectal sensation but normal sphincter pressures was studied. In both patients and normal subjects, the onset and duration of rectal sensation correlated closely with the external anal sphincter electrical activity (r = 0.8, p less than 0.0001) and with rectal contraction (r = 0.51, p less than 0.001), but not with internal sphincter relaxation. All normal subjects perceived a rectal sensation within one second of rapid inflation of a rectal balloon with volumes of 20 ml or less air. Six patients did not perceive any rectal sensation until 60 ml had been introduced, while in the remaining nine patients the sensation was delayed by at least two seconds. Internal sphincter relaxation occurred before the sensation was perceived in three of 27 normal subjects and 11 of 16 patients (p less than 0.001), and could be associated with anal leakage, which stopped as soon as sensation was perceived. The lowest rectal volumes required to induce anal relaxation, to cause sustained relaxation, or to elicit sensations of a desire to defecate or pain were similar in patients and normal subjects. In conclusion, these results show the close association between rectal sensation and external anal sphincter contraction, and show that faecal incontinence may occur as a result of delayed or absent external anal sphincter contraction when the internal anal sphincter is relaxed.<\/jats:p>","DOI":"10.1136\/gut.31.9.1056","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"1056-1061","source":"Crossref","is-referenced-by-count":130,"title":["Relation between rectal sensation and anal function in normal subjects and patients with faecal incontinence."],"prefix":"10.1136","volume":"31","author":[{"given":"W M","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N W","family":"Read","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P B","family":"Miner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1990,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1172\/JCI104706","article-title":"The internal anal sphincter response: menometric studies on its normal physiology, neural pathways and alteration in bowel disorders","volume":"42","author":"Schuster, M.M.; Hendrix, T.R.; Al, Mendeloff","year":"1963","unstructured":"Schuster MM, Hendrix TR, Mendeloff Al. The internal anal sphincter response: menometric studies on its normal physiology, neural pathways and alteration in bowel disorders. J Clin Invest 1963; 42: 196-207.","journal-title":"J Clin Invest"},{"key":"ref_2","first-page":"249","volume-title":"The riddle of the sphincter. Gastroenterology 1975; 69","author":"Schuster, M.M.","unstructured":"Schuster MM. The riddle of the sphincter. Gastroenterology 1975; 69: 249-62."},{"key":"ref_3","first-page":"3942","article-title":"Differences in anal function in patients with incontinence to solids and in patients with incontinence to liquids","volume":"71","author":"Read NW, Bartolo DCC, Read MG","year":"1984","unstructured":"Read NW, Bartolo DCC, Read MG. Differences in anal function in patients with incontinence to solids and in patients with incontinence to liquids. 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A dynamic assessment of the anal continence mechanism","volume":"330","author":"Haynes WV, Read NW","year":"1982","unstructured":"Haynes WV, Read NW. Anorectal activity in man during rectal infusion of saline. A dynamic assessment of the anal continence mechanism. J Physiol 1982; 330: 45-56.","journal-title":"J Physiol"},{"key":"ref_9","first-page":"2121","article-title":"Motor action of rectum and anal sphincters in continence and defecation","volume":"1968","author":"Schuster, M.M.","unstructured":"Schuster MM. Motor action of rectum and anal sphincters in continence and defecation. In: Handbook of physiology alimentary canal. Section 6, Vol IV. Washington, DC: American Physiology Society, 1968: 2121-46.","journal-title":"Handbook of physiology alimentary canal. Section 6, Vol IV; American Physiology Society"},{"key":"ref_10","first-page":"593","article-title":"Tension receptors in the stomach and the urinary bladder","volume":"128","author":"Iggo, A.","year":"1955","unstructured":"Iggo A. Tension receptors in the stomach and the urinary bladder. JPhysiol 1955; 128: 593-607.","journal-title":"JPhysiol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1542\/peds.68.1.45","article-title":"Use of biofeedback in treatment of fecal incontinence in patients with meningomyelocele","volume":"68","author":"Wald, A.","year":"1981","unstructured":"Wald A. Use of biofeedback in treatment of fecal incontinence in patients with meningomyelocele. Pediatrics 1981; 68: 45-9.","journal-title":"Pediatrics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1056\/NEJM198405173102003","article-title":"Anorectal sensation dysfunction in fecal incontinence and diabetes mellitus","volume":"310","author":"Wald, A.; Tunuguntla, A.K.","year":"1984","unstructured":"Wald A, Tunuguntla AK. Anorectal sensation dysfunction in fecal incontinence and diabetes mellitus. N Engl J Med 1984; 310: 1282-7.","journal-title":"N Engl J Med"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1136\/gut.27.3.283","article-title":"Read NW, Abouzekry L. Why do patients with faecal impaction have faecal incontinence?","volume":"27","year":"1986","unstructured":"Read NW, Abouzekry L. Why do patients with faecal impaction have faecal incontinence? 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