Loening-Baucke V A
J Pediatr Gastroenterol Nutr. 1984 Jun;3(3):454-9. doi: 10.1097/00005176-198406000-00026.
Sensations in the sigmoid and rectum and the response of the anal canal to balloon distension were measured with a latex balloon and pressure transducer in 15 chronically constipated and 15 healthy control children. The constipated children received milk of magnesia and bowel training. Thirteen constipated children were restudied 7-12 months later and 11 were restudied 3 years later. Although thresholds of transient sensation and of the rectosphincteric reflex were not different in constipated and control children, the threshold of fullness, the critical volume, and the volume for constant relaxation were significantly higher in constipated than in control children (p less than 0.05), and remained higher 1 year and 3 years later, even in the children who recovered. The initial data support the concept of a sigmoid and rectum so enlarged that a normal fecal bolus may not cause a sensation of fullness or a sensory stimulus for defecation. Despite improvement in clinical manifestations and normal rectal size, the abnormalities in sensitivity of the sigmoid and rectum persisted in five of eight recovered children. This may explain why these children are so vulnerable to recurrence of constipation and fecal soiling.
使用乳胶气球和压力传感器，对15名慢性便秘儿童和15名健康对照儿童测量了乙状结肠和直肠的感觉以及肛管对气囊扩张的反应。便秘儿童接受了氧化镁乳剂治疗和排便训练。13名便秘儿童在7至12个月后再次接受检查，11名在3年后再次接受检查。虽然便秘儿童和对照儿童的瞬时感觉阈值和直肠括约肌反射阈值没有差异，但便秘儿童的饱腹感阈值、临界容量和持续松弛容量显著高于对照儿童（p<0.05），即使在恢复的儿童中，1年和3年后这些指标仍较高。初始数据支持乙状结肠和直肠扩张到正常粪块可能不会引起饱腹感或排便感觉刺激的概念。尽管临床表现有所改善且直肠大小正常，但8名恢复的儿童中有5名乙状结肠和直肠的敏感性异常仍然存在。这可能解释了为什么这些儿童如此容易复发便秘和大便失禁。
