Defecatory disorders (DD), which commonly cause chronic constipation, are diagnosed by clinical features supplemented by abnormal anorectal tests, and should be managed by pelvic floor retraining by biofeedback therapy rather than by laxatives. DD are attributed to "maladaptive" pelvic floor contraction during defecation. This paradigm overlooks the contribution of visceral disturbances (e.g., increased anal resting pressure or anal hypertension). Biofeedback therapy is not widely available and there are no pharmacological approaches to manage DD currently. Anorectal tests are not widely available, and the accuracy of a key diagnostic test, i.e. a negative rectoanal gradient (rectal

Public Health Relevance

Defecatory disorders (DD) commonly cause chronic constipation. Our studies have the potential to refine diagnostic tests for DD, uncover a mechanism responsible for DD, and identify a new medication for DD, which are currently managed by pelvic floor retraining by biofeedback therapy that is not widely available.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
2R01DK078924-05
Application #
8711638
Study Section
Special Emphasis Panel (ZRG1-DKUS-N (03))
Program Officer
Hamilton, Frank A
Project Start
2008-04-01
Project End
2019-01-31
Budget Start
2014-04-01
Budget End
2015-01-31
Support Year
5
Fiscal Year
2014
Total Cost
$345,825
Indirect Cost
$128,325
Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905
Prichard, David; Bharucha, Adil E (2014) Management of pelvic floor disorders: biofeedback and more. Curr Treat Options Gastroenterol 12:456-67
Bharucha, Adil E; Rao, Satish S C (2014) An update on anorectal disorders for gastroenterologists. Gastroenterology 146:37-45.e2
Bharucha, Adil E; Fletcher, Joel G; Camilleri, Michael et al. (2014) Effects of clonidine in women with fecal incontinence. Clin Gastroenterol Hepatol 12:843-851.e2; quiz e44
Ratuapli, Shiva K; Bharucha, Adil E; Noelting, Jessica et al. (2013) Phenotypic identification and classification of functional defecatory disorders using high-resolution anorectal manometry. Gastroenterology 144:314-322.e2
Casiano, Elizabeth R; Trabuco, Emanuel C; Bharucha, Adil E et al. (2013) Risk of oophorectomy after hysterectomy. Obstet Gynecol 121:1069-74
Bharucha, Adil E; Pemberton, John H; Locke 3rd, G Richard (2013) American Gastroenterological Association technical review on constipation. Gastroenterology 144:218-38
Ratuapli, S; Bharucha, A E; Harvey, D et al. (2013) Comparison of rectal balloon expulsion test in seated and left lateral positions. Neurogastroenterol Motil 25:e813-20
Bharucha, Adil E; Fletcher, J G; Melton 3rd, L Joseph et al. (2012) Obstetric trauma, pelvic floor injury and fecal incontinence: a population-based case-control study. Am J Gastroenterol 107:902-11
Bharucha, Adil E (2011) Recent advances in functional anorectal disorders. Curr Gastroenterol Rep 13:316-22
Bharucha, Adil E; Edge, Jessica; Zinsmeister, Alan R (2011) Effect of nifedipine on anorectal sensorimotor functions in health and fecal incontinence. Am J Physiol Gastrointest Liver Physiol 301:G175-80

Showing the most recent 10 out of 22 publications