Shafik A
Department of Surgery and Research, Faculty of Medicine, Cairo University, Egypt.
Int Surg. 1993 Jan-Mar;78(1):83-5.
The present communication describes the "esophago-rectal reflex" and its clinical significance. The study was performed in 19 healthy volunteers and 14 constipated subjects. The technique comprised the introduction into the esophagus of a balloon-tipped tube so that the balloon lay within the lower esophageal sphincter (LES). The rectal and rectal neck pressures were measured by means of perfused open-ended tubes. The esophageal balloon was inflated with 2, 4 and 6 ml water and the responses of the rectal and rectal neck pressures were recorded. Distension of the LES was accompanied by significant rectal pressure increase (P < 0.001); the pressure increased with increasing LES distension. Anesthetized LES mucosa did not evoke the rectal pressure response. The rectal neck pressure did not show significant change with LES distension (P > 0.05). Both the rectal and rectal neck pressures showed insignificant response to LES distension in constipated subjects (P > 0.05). The esophago-rectal reflex seems to be conducted through the myenteric plexus from the esophagus down along the gut wall to the rectum, initiating rectal contractions. It is likely that these signals alarm the rectum for the entrance of new contents in the gut so that the rectum may evacuate its contents.
本通讯描述了“食管 - 直肠反射”及其临床意义。该研究在19名健康志愿者和14名便秘患者中进行。技术包括将带气囊的导管插入食管，使气囊位于食管下括约肌（LES）内。通过灌注开放式导管测量直肠和直肠颈部压力。用2、4和6毫升水使食管气囊膨胀，并记录直肠和直肠颈部压力的反应。LES扩张伴随着直肠压力显著增加（P < 0.001）；压力随着LES扩张程度增加而升高。麻醉LES黏膜不会引起直肠压力反应。LES扩张时直肠颈部压力无显著变化（P > 0.05）。便秘患者中直肠和直肠颈部压力对LES扩张的反应均不显著（P > 0.05）。食管 - 直肠反射似乎是通过肌间神经丛从食管沿肠壁向下传导至直肠，引发直肠收缩。这些信号可能是为了提醒直肠肠道中有新内容物进入，以便直肠排出其内容物。
