Division of Gastroenterology, University of Texas Medical Branch, Galveston, TX 77555-0655, USA.
Am J Physiol Regul Integr Comp Physiol. 2010 Sep;299(3):R953-9. doi: 10.1152/ajpregu.00439.2009. Epub 2010 Jun 16.
Distention of the proximal colon may have inhibitory or excitatory effects on the rectum and vice versa. The reflexes between the proximal colon and the rectum have not been well studied due to difficulties in accessing the proximal colon. The aim of this study was to investigate the reflex responses and their mechanisms between the proximal colon and the rectum in consideration of distention-related changes in tone and compliance of these regions as well as anal sphincter relaxation in a canine model. Proximal colon/rectal tone, compliance, and anal sphincter relaxation were investigated in six dogs chronically implanted with a proximal colon cannula while in the fasting state and during proximal colon distention or rectal distention. It was found that: 1) both rectal distention and proximal colon distention significantly and substantially decreased the compliance of the opposite regions, and guanethidine abolished proximal colon distention-induced changes in rectal compliance; 2) rectal/proximal colon distension decreased proximal colonic/rectal tone, and guanethidine abolished both of these inhibitory effects; 3) the anal sphincter was more sensitive to rectal distention than proximal colon distention; and 4) the minimal distention pressure required to induce anal inhibitory reflex was lower for rectal distention than proximal colon distention. It was concluded that distention-related changes in tone and compliance suggest the long inhibitory reflexes between the proximal colon and the rectum with the sympathetic involvement in rectal responses. The anal sphincter is more sensitive to the distention of the rectum than that of the proximal colon.
近端结肠扩张可能对直肠产生抑制或兴奋作用,反之亦然。由于近端结肠难以接近,因此近端结肠和直肠之间的反射尚未得到很好的研究。本研究旨在探讨犬模型中考虑到这些区域的张力和顺应性与肛门括约肌松弛与近端结肠和直肠之间的反射反应及其机制。在六只慢性植入近端结肠套管的狗中,在空腹状态和近端结肠扩张或直肠扩张期间,研究了近端结肠/直肠张力、顺应性和肛门括约肌松弛。结果发现:1)直肠扩张和近端结肠扩张均显著且实质性地降低了相反区域的顺应性,胍乙啶消除了近端结肠扩张引起的直肠顺应性变化;2)直肠/近端结肠扩张降低了近端结肠/直肠张力,胍乙啶消除了这两种抑制作用;3)肛门括约肌对直肠扩张比近端结肠扩张更敏感;4)引起肛门抑制反射的最小扩张压力,直肠扩张低于近端结肠扩张。结论是,张力和顺应性的扩张相关变化表明,近端结肠和直肠之间存在长抑制反射,涉及到直肠反应的交感神经参与。肛门括约肌对直肠扩张比近端结肠扩张更敏感。