{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:43:30Z","timestamp":1765611810139,"version":"3.48.0"},"reference-count":34,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"accepted":{"date-parts":[[1997,4,10]]},"published-print":{"date-parts":[[1997,10,1]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    \u2014The pathogenesis of anorectal dysfunction, which occurs frequently in patients with diabetes mellitus, is poorly defined. Recent studies indicate that changes in the blood glucose concentration have a major reversible effect on gastrointestinal motor function.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Aims<\/jats:italic>\n                    \u2014To determine the effects of physiological changes in blood glucose and hyperglycaemia on anorectal motor and sensory function in normal subjects.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Subjects<\/jats:italic>\n                    \u2014In eight normal subjects measurements of anorectal motility and sensation were performed on separate days while blood glucose concentrations were stabilised at 4, 8, and 12\u2009mmol\/l.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods<\/jats:italic>\n                    \u2014Anorectal motor and sensory function was measured using a sleeve\/sidehole catheter incorporating a balloon, and electromyography.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results<\/jats:italic>\n                    \u2014The number of spontaneous anal relaxations was greater at 12\u2009mmol\/l than at 8 and 4\u2009mmol\/l glucose (p&lt;0.05 for both). Anal squeeze pressures were less at a blood glucose of 12\u2009mmol\/l when compared with 8 and 4\u2009mmol\/l (p&lt;0.05 for both). During rectal distension, residual anal pressures were not significantly different between the three blood glucose concentrations. Rectal compliance was greater (p&lt;0.05) at a blood glucose of 12\u2009mmol\/l when compared with 4\u2009mmol\/l. The threshold volume for initial perception of rectal distension was less at 12\u2009mmol\/l when compared with 4\u2009mmol\/l (40 (20\u2013100) ml versus 10 (10\u2013150) ml, p&lt;0.05).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    \u2014An acute elevation of blood glucose to 12\u2009mmol\/l inhibits internal and external anal sphincter function and increases rectal sensitivity in normal subjects. In contrast, physiological changes in blood glucose do not have a significant effect on anorectal motor and sensory function.\n                  <\/jats:p>","DOI":"10.1136\/gut.41.4.494","type":"journal-article","created":{"date-parts":[[2010,6,30]],"date-time":"2010-06-30T12:46:12Z","timestamp":1277901972000},"page":"494-499","source":"Crossref","is-referenced-by-count":33,"title":["Acute hyperglycaemia affects anorectal motor and sensory function in normal subjects"],"prefix":"10.1136","volume":"41","author":[{"given":"A","family":"Russo","sequence":"first","affiliation":[{"name":"University Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W M","family":"Sun","sequence":"additional","affiliation":[{"name":"University Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Sattawatthamrong","sequence":"additional","affiliation":[{"name":"University Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Fraser","sequence":"additional","affiliation":[{"name":"University Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Horowitz","sequence":"additional","affiliation":[{"name":"University Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J M","family":"Andrews","sequence":"additional","affiliation":[{"name":"University Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N W","family":"Read","sequence":"additional","affiliation":[{"name":"University Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1997,10,1]]},"reference":[{"key":"2025121223395127000_41.4.494.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-98-3-378"},{"key":"2025121223395127000_41.4.494.2","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1056\/NEJM198212303072702","article-title":"Pathogenesis of fecal incontinence in diabetes mellitus\u2014evidence for internal-anal-sphincter dysfunction.","volume":"307","author":"Schiller","year":"1982","journal-title":"N Engl J Med"},{"key":"2025121223395127000_41.4.494.3","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1056\/NEJM198405173102003","article-title":"Anorectal sensorimotor dysfunction in fecal incontinence and diabetes mellitus\u2014modification with biofeedback therapy.","volume":"310","author":"Wald","year":"1984","journal-title":"N Engl J Med"},{"key":"2025121223395127000_41.4.494.4","doi-asserted-by":"publisher","DOI":"10.1136\/gut.29.6.756"},{"key":"2025121223395127000_41.4.494.5","first-page":"2109","article-title":"Colonic and anorectal motility testing in clinical practice.","volume":"89","author":"Wald","year":"1994","journal-title":"Am J Gastroenterol"},{"key":"2025121223395127000_41.4.494.6","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199610000-00014"},{"key":"2025121223395127000_41.4.494.7","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(91)90217-9"},{"key":"2025121223395127000_41.4.494.8","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)90005-J"},{"key":"2025121223395127000_41.4.494.9","doi-asserted-by":"publisher","DOI":"10.1007\/BF00400569"},{"key":"2025121223395127000_41.4.494.10","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(88)90248-X"},{"key":"2025121223395127000_41.4.494.11","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1136\/gut.32.5.475","article-title":"Hyperglycaemia stimulates pyloric motility in normal subjects.","volume":"31","author":"Fraser","year":"1991","journal-title":"Gut"},{"key":"2025121223395127000_41.4.494.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1993.tb00141.x"},{"key":"2025121223395127000_41.4.494.13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00042737-199603000-00005","article-title":"Hyperglycaemia affects proximal gastric motor and sensory function in normal subjects.","volume":"8","author":"Hebbard","year":"1996","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2025121223395127000_41.4.494.14","first-page":"6814","article-title":"Hyperglycaemia affects proximal gastric motor and sensory function during small intestinal triglyceride infusion.","volume":"271","author":"Hebbard","year":"1996","journal-title":"Am J Physiol"},{"key":"2025121223395127000_41.4.494.15","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90445-X"},{"key":"2025121223395127000_41.4.494.16","doi-asserted-by":"publisher","DOI":"10.3109\/00365529409094894"},{"key":"2025121223395127000_41.4.494.17","doi-asserted-by":"publisher","DOI":"10.1007\/BF00403919"},{"key":"2025121223395127000_41.4.494.18","doi-asserted-by":"publisher","DOI":"10.1007\/BF01299901"},{"key":"2025121223395127000_41.4.494.19","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90060-8"},{"key":"2025121223395127000_41.4.494.20","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90131-0"},{"key":"2025121223395127000_41.4.494.21","first-page":"A636","article-title":"Physiological variations in blood glucose concentration affect oesophageal motility and sensation in normal subjects [abstract].","volume":"110","author":"Boeckxstaens","year":"1996","journal-title":"Gastroenterology"},{"key":"2025121223395127000_41.4.494.22","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(89)90184-0"},{"key":"2025121223395127000_41.4.494.23","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(97)70080-5"},{"key":"2025121223395127000_41.4.494.24","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/0016-5085(91)90277-R","article-title":"Human anal motility while fasting, after feeding, and during sleep.","volume":"100","author":"Orkin","year":"1991","journal-title":"Gastroenterology"},{"key":"2025121223395127000_41.4.494.25","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.1979.237.3.E214"},{"key":"2025121223395127000_41.4.494.26","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(90)90620-G"},{"key":"2025121223395127000_41.4.494.27","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/0016-5085(89)91425-X","article-title":"Impaired internal anal sphincter in a subgroup of patients with idiopathic faecal incontinence.","volume":"97","author":"Sun","year":"1989","journal-title":"Gastroenterology"},{"key":"2025121223395127000_41.4.494.28","unstructured":"Read NW Sun WM (1992) Anorectal manometry. in Coloproctology and pelvic floor. eds Henry M Swash M (Butterworths, London), 2nd edn. pp 119\u2013145."},{"key":"2025121223395127000_41.4.494.29","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/BF00496147","article-title":"The role of transient internal sphincter relaxation in faecal incontinence?","volume":"5","author":"Sun","year":"1990","journal-title":"Int J Colorect Dis"},{"key":"2025121223395127000_41.4.494.30","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(96)00147-2"},{"key":"2025121223395127000_41.4.494.31","first-page":"A707","article-title":"Physiological changes in the plasma glucose concentration modify the antropyloroduodenal motor and sensory responses to duodenal distension [abstract].","volume":"110","author":"Lingenfelser","year":"1996","journal-title":"Gastroenterology"},{"key":"2025121223395127000_41.4.494.32","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1023\/A:1018851227051","article-title":"Hyperglycemia affects gastric electrical rhythm and nausea during intraduodenal triglyceride infusion.","volume":"42","author":"Hebbard","year":"1977","journal-title":"Dig Dis Sci"},{"key":"2025121223395127000_41.4.494.33","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.19.8.880"},{"key":"2025121223395127000_41.4.494.34","doi-asserted-by":"publisher","DOI":"10.1016\/0026-0495(86)90189-7"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.41.4.494","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:40:02Z","timestamp":1765611602000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.41.4.494"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,10,1]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1997,10,1]]},"published-print":{"date-parts":[[1997,10,1]]}},"alternative-id":["10.1136\/gut.41.4.494"],"URL":"https:\/\/doi.org\/10.1136\/gut.41.4.494","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"type":"print","value":"0017-5749"},{"type":"electronic","value":"1468-3288"}],"subject":[],"published":{"date-parts":[[1997,10,1]]}}}