Role of sympathetic innervation in the defecation mechanism: a novel concept of its function. 2003

Ahmed Shafik, and Ali A Shafik, and Olfat El-Sibai, and Ismail Ahmed
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt. shafik@ahmed-shafik.org

OBJECTIVE Because the role of sympathetic innervation in the defecation mechanism is still vague and unidentified, this study was performed to investigate this issue. METHODS The effect of individual administration of alpha- and beta-adrenoceptor blocking agents (3 mg/kg phentolamine mesylate and 1 mg/kg propranolol hydrochloride, respectively) and the effect of thoracolumbar sympathectomy on anal and rectal pressures was studied in 13 mongrel dogs. Pressures were measured by a 2-channel microtip catheter. Bilateral thoracolumbar sympathectomy was performed by excising the sympathetic ganglia from T11 to L2. Incremental rectal filling using a rectal balloon with simultaneous anal and rectal pressure measurements was continued until balloon expulsion was achieved. RESULTS Rectal balloon distension with 30 to 40 mL of saline affected rectal pressure increase (P < 0.001 ), anal pressure decrease (P < 0.01), and balloon expulsion. Following administration of either phentolamine or propranolol or after thoracolumbar sympathectomy, rectal pressure declined (P < 0.05), but anal pressure showed no change (P > 0.05). At a rectal balloon volume of 50 to 60 mL of saline, rectal pressure increased (P < 0.001), anal pressure decreased (P < 0.01), and the balloon was expelled. CONCLUSIONS Sympathetic rectal innervation may have a role during both the filling and evacuation phases of the defecation mechanism. During rectal filling, it most likely maintains rectal compliance. During evacuation in cases of rectal sympathetic block or denervation, a larger volume than usual of rectal distension is needed to induce rectal contraction and evacuation.

UI MeSH Term Description Entries
D008297 Male Males
D010646 Phentolamine A nonselective alpha-adrenergic antagonist. It is used in the treatment of hypertension and hypertensive emergencies, pheochromocytoma, vasospasm of RAYNAUD DISEASE and frostbite, clonidine withdrawal syndrome, impotence, and peripheral vascular disease. Fentolamin,Phentolamine Mesilate,Phentolamine Mesylate,Phentolamine Methanesulfonate,Phentolamine Mono-hydrochloride,Regitine,Regityn,Rogitine,Z-Max,Mesilate, Phentolamine,Mesylate, Phentolamine,Methanesulfonate, Phentolamine,Mono-hydrochloride, Phentolamine,Phentolamine Mono hydrochloride
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D011433 Propranolol A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs. Dexpropranolol,AY-20694,Anaprilin,Anapriline,Avlocardyl,Betadren,Dociton,Inderal,Obsidan,Obzidan,Propanolol,Propranolol Hydrochloride,Rexigen,AY 20694,AY20694,Hydrochloride, Propranolol
D012002 Rectal Diseases Pathological developments in the RECTUM region of the large intestine (INTESTINE, LARGE). Anorectal Diseases,Anorectal Disorders,Rectal Disorders,Anorectal Disease,Anorectal Disorder,Rectal Disease,Rectal Disorder
D012007 Rectum The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL. Rectums
D002404 Catheterization Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions. Cannulation,Cannulations,Catheterizations
D003672 Defecation The normal process of elimination of fecal material from the RECTUM. Bowel Function,Bowel Movement,Bowel Functions,Bowel Movements,Defecations
D004195 Disease Models, Animal Naturally-occurring or experimentally-induced animal diseases with pathological processes analogous to human diseases. Animal Disease Model,Animal Disease Models,Disease Model, Animal
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog

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