The Sphincter of O'Beirne - Part 1: Study of 18 Normal Subjects.
Dig Dis Sci
; 66(10): 3516-3528, 2021 10.
Article
em En
| MEDLINE
| ID: mdl-33462748
ABSTRACT
BACKGROUND:
Gastroenterologists have ignored or emphasized the importance of the rectosigmoid junction in continence or constipation on and off for 200 years. Here, we revisit its significance using high-resolution colonic manometry.METHODS:
Manometry, using an 84-channel water-perfused catheter, was performed in 18 healthy volunteers.RESULTS:
The rectosigmoid junction registers as an intermittent pressure band of 26.2 ± 7.2 mmHg, or intermittent phasic transient pressure increases at a dominant frequency of 3 cpm and an amplitude of 28.6 ± 8.6 mmHg; or a combination of tone and transient pressures, at a single sensor, 10-17 cm above the anal verge. Features are its relaxation or contraction in concert with relaxation or contraction of the anal sphincters when a motor pattern such as a high-amplitude propagating pressure wave or a simultaneous pressure wave comes down, indicating that such pressure increases or decreases at the rectosigmoid junction are part of neurally driven programs. We show that the junction is a site where motor patterns end, or where they start; e.g. retrogradely propagating cyclic motor patterns emerge from the junction.CONCLUSIONS:
The rectosigmoid junction is a functional sphincter that should be referred to as the sphincter of O'Beirne; it is part of the "braking mechanism," contributing to continence by keeping content away from the rectum. In an accompanying case report, we show that its excessive presence in a patient with severe constipation can be a primary pathophysiology.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Reto
/
Colo Sigmoide
Limite:
Adult
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Female
/
Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article