Shafik A
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University,
Hepatogastroenterology. 2000 Jul-Aug;47(34):1030-3.
BACKGROUND/AIMS: To study the effect of rectal distension on jejunal and ileal motility aiming at the assessment of the possible role of rectal distension induced by constipation on the transport of the material in the gut.
The rectum of 16 healthy volunteers (mean age: 38.6 +/- 11.7 years, 10 men, and 6 women) was distended by a balloon filled with water in increments of 50 mL up to 200 mL and the response of the jejunal and ileal pressures was recorded. The test was repeated distending the anesthetized rectum 20 min and 3 hours after anesthetization.
Rectal distension with 50 mL of water effected no jejunal or ileal pressure changes (P > 0.05). One hundred-mililitre (100-mL) rectal distension produced decrease of jejunal and ileal pressures (P < 0.05) which lasted as long as distension was maintained. Rectal distension with 150 and 200 mL caused jejunal and ileal pressure response similar to that of the 100 mL distension (P > 0.05). Distension of the anesthetized rectum effected no significant jejunal or ileal pressure changes.
The results were reproducible in the individual subject. The decline of the intestinal pressure upon rectal distension postulates a reflex relationship between the 2 conditions. This reflex nature is evidenced by reproducibility and by its absence on distension of the anesthetized rectum. We termed this reflex relation: "recto-enteric reflex". It is suggested that under normal physiologic conditions the reflex inhibits the intestinal transit, thus giving the rectum time to evacuate itself. Continuous rectal distension, as occurs in inertia constipation, appears to effect enteric hypotonia, a hypothesis which requires further studies.
背景/目的：研究直肠扩张对空肠和回肠运动的影响，旨在评估便秘引起的直肠扩张在肠道物质运输中可能发挥的作用。
对16名健康志愿者（平均年龄：38.6±11.7岁，男性10名，女性6名）的直肠用充水气球以50 mL递增直至200 mL进行扩张，并记录空肠和回肠压力的反应。在麻醉后20分钟和3小时对麻醉的直肠进行扩张，重复该试验。
用50 mL水扩张直肠未引起空肠或回肠压力变化（P>0.05）。100 mL直肠扩张使空肠和回肠压力降低（P<0.05），只要扩张持续，压力就持续降低。150 mL和200 mL直肠扩张引起的空肠和回肠压力反应与100 mL扩张相似（P>0.05）。麻醉直肠的扩张未引起空肠或回肠压力的显著变化。
结果在个体受试者中具有可重复性。直肠扩张时肠内压力下降表明这两种情况之间存在反射关系。这种反射性质通过可重复性以及麻醉直肠扩张时不存在这种反射得以证明。我们将这种反射关系称为：“直肠-肠反射”。提示在正常生理条件下，该反射抑制肠道转运，从而给直肠时间排空自身。如在习惯性便秘中出现的持续性直肠扩张似乎会导致肠道张力减退，这一假说需要进一步研究。
