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In vitro Functional Characterization of Mouse Colorectal Afferent Endings

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Recto-colic reflex: role in the defecation mechanism

¹Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Egypt.

International Surgery

|July 1, 1996

Summary

A newly identified recto-colic reflex explains how the colon feeds stool to the rectum during defecation. This reflex, crucial for emptying the colon, may be implicated in defecation disorders when impaired.

Area of Science:

Gastroenterology
Colorectal Surgery
Neurogastroenterology

Background:

The colon's role in continuously supplying stool to the rectum during defecation is a postulated mechanism.
The precise relationship between rectal distension and colonic activity during defecation requires further investigation.

Purpose of the Study:

To investigate the relationship between rectal distension and colonic pressure responses.
To identify and characterize a potential recto-colic reflex involved in defecation.

Main Methods:

Studied 11 patients with transverse colostomy after colectomy for colon cancer.
Rectal distension was induced using a catheter, with colonic pressures measured via balloon catheters.
Tests were repeated with rectal or colonic anesthesia to assess reflex pathways.

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Main Results:

Rectal distension up to the point of defecation urge did not elicit a colonic pressure response.
At the point of defecation urge, significant left colonic pressure rise was observed (p<0.001), with no right colon response.
Anesthesia of the rectum or colon abolished the colonic pressure response to rectal distension, indicating a reflex mechanism.

Conclusions:

A recto-colic reflex, triggered by rectal distension, causes left colonic contractions to facilitate stool transfer to the rectum.
This reflex is essential for the sequential emptying of the colon during defecation.
Derangements in this recto-colic reflex may contribute to the pathophysiology of defecation disorders.