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Related Experiment Videos

Idiopathic constipation associated with impaired urethrovesical and sacral reflex function.

D D Kerrigan1, M G Lucas, W M Sun

  • 1Department of Surgery, Royal Hallamshire Hospital, Sheffield, UK.

The British Journal of Surgery
|July 1, 1989
PubMed
Summary

Chronic constipation in women may stem from impaired sacral reflexes. This study found that 75% of constipated women lacked key reflexes, unlike healthy controls, suggesting a neurological basis for their condition.

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Area of Science:

  • Neuroscience
  • Gastroenterology
  • Urology

Background:

  • Chronic idiopathic constipation (CIC) is a prevalent condition with significant impact on quality of life.
  • The underlying pathophysiology of CIC, particularly in women, remains incompletely understood.
  • Pelvic spinal reflex integrity is crucial for normal anorectal and bladder function.

Purpose of the Study:

  • To investigate the neurophysiological basis of chronic constipation in women.
  • To assess the integrity of pelvic spinal reflexes in chronically constipated women compared to healthy controls.
  • To correlate neurophysiological findings with urodynamic and anorectal manometry data.

Main Methods:

  • Neurophysiological assessment via electrical stimulation of the dorsogenital nerve.

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  • Recording evoked reflex activity in external anal and urethral sphincters using needle and surface electrodes.
  • Comparison with videourodynamic studies and anorectal manometry with electromyography.

    • Main Results:

    • 75% of constipated women showed absence of one or more sacral reflexes, versus 20% of controls (P<0.05).
    • 56% of constipated women had urodynamic abnormalities; 38% lacked defecation urge, and 73% failed to relax the external anal sphincter during defecation.
    • Sensory thresholds and motor unit potentials in the external anal sphincter were similar between groups.

    Conclusions:

    • Impaired integration of sensory information within the sacral cord is suggested as a potential cause of chronic idiopathic constipation in women.
    • Deficits in sacral reflexes and altered rectal sensation contribute to defecation dysfunction.
    • Findings highlight the neurological underpinnings of CIC and warrant further investigation into targeted neuro-rehabilitative therapies.