Anorectal Stimulation Causes Increased Colonic Motor Activity in Subjects With Spinal Cord Injury

Background: Difficulty with evacuation (DWE) is a major problem after spinal cord injury (SCI). Stimulation of the anal canal and lower rectum, accomplished using a gloved finger (so-called digital rectal stimulation or DRS) is often used as an adjunct to laxatives and enemas to facilitate bowel eva...

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Bibliographic Details
Published in:The journal of spinal cord medicine 2007-01, Vol.30 (1), p.31-35
Main Authors: Korsten, Mark A., Singal, Ashwani K., Monga, Amit, Chaparala, Geeta, Khan, Amir M., Palmon, Ron, Mendoza, John Reagan D., Lirio, Juan P., Rosman, Alan S., Spungen, Ann, Bauman, William A.
Format: Article
Language:English
Subjects:
Adult
Anal Canal - physiopathology
Anorectal colonic reflex
Colon, Descending - physiopathology
Colonic motility
Colonoscopes
Defecation - physiology
Digital rectal stimulation
Fluoroscopy
Gastrointestinal Motility - physiology
Humans
Male
Manometry - instrumentation
Middle Aged
Neurogenic bowel
Original Contribution
Paraplegia
Paraplegia - physiopathology
Peristalsis - physiology
Physical Stimulation
Quadriplegia - physiopathology
Rectum - physiopathology
Reflex - physiology
Spinal Cord Injuries - physiopathology
Spinal cord injury
Tetraplegia
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Summary:Background: Difficulty with evacuation (DWE) is a major problem after spinal cord injury (SCI). Stimulation of the anal canal and lower rectum, accomplished using a gloved finger (so-called digital rectal stimulation or DRS) is often used as an adjunct to laxatives and enemas to facilitate bowel evacuation. However, the basis for the efficacy of DRS is not known. This study assessed the effect of DRS on colonic motility. Methods: Six subjects with SCI were studied several hours after a bowel care session. Colonic motility was assessed using a manometric catheter (affixed endoscopically to the splenic flexure) at baseline, during DRS, and after DRS. In addition, evacuation of barium oatmeal paste (with the consistency of stool and introduced into the rectum and descending colon) was assessed simultaneously using fluoroscopic techniques. Results: The mean number (± SEM) of peristaltic waves per minute increased from 0 at baseline to 1.9 (±0.5/min) during DRS and 1.5 (±0.3/min) during the period immediately after cessation of DRS (P
ISSN:1079-0268
2045-7723
DOI:10.1080/10790268.2007.11753911