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Rectoanal reflex induced by H2O thermal stimulation
A Nagasaki1, K Ikeda, K Sumitomo
1Department of Pediatric Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Diseases of the Colon and Rectum
|September 1, 1989
Summary
Cold water reliably elicits the rectoanal reflex in healthy individuals, aiding diagnosis. This method is effective for identifying the rectoanal reflex, even in cases of Hirschsprung
Area of Science:
- Gastroenterology
- Neurogastroenterology
- Physiology
Background:
- The rectoanal reflex is a critical indicator of anorectal function.
- Accurate assessment of the rectoanal reflex is essential for diagnosing conditions like Hirschsprung's disease.
Purpose of the Study:
- To investigate the efficacy of cold water stimulation in eliciting the rectoanal reflex.
- To compare cold water stimulation with balloon distention for rectoanal reflex assessment.
- To determine the optimal temperature for cold water stimulation of the rectoanal reflex.
Main Methods:
- Rectal administration of cold water at varying temperatures (4°C, 17°C, 27°C, 37°C, 45°C).
- Rectal balloon distention for comparison.
- Evaluation of rectoanal reflex presence in healthy subjects and patients with Hirschsprung's disease.
Main Results:
- Cold water (4°C and 17°C) consistently induced the rectoanal reflex in healthy patients.
- The rectoanal reflex was absent in patients with Hirschsprung's disease, regardless of stimulation method or water temperature.
- The reflex was occasionally present at 27°C and 45°C, and absent at 37°C.
Conclusions:
- Cold water stimulation is a safe and effective method for assessing the rectoanal reflex, particularly when results are equivocal.
- The study suggests the rectoanal reflex receptor is neuronal and located near the rectal mucosa.
- Cold water stimulation offers a valuable, non-distending alternative for rectoanal reflex testing.