Abstract

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.

  Funding Agency

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

  Institution

Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905

  Publications

Bedard, K; Heymen, S; Palsson, O S et al. (2018) Relationship between symptoms and quality of life in fecal incontinence. Neurogastroenterol Motil 30:
Lee, Tae Hee; Setty, Pratyusha Tirumani; Parthasarathy, Gopanandan et al. (2018) Aging, Obesity, and the Incidence of Diverticulitis: A Population-Based Study. Mayo Clin Proc 93:1256-1265
Sharma, M; Feuerhak, K; Zinsmeister, A R et al. (2018) A pharmacological challenge predicts reversible rectal sensorimotor dysfunctions in women with fecal incontinence. Neurogastroenterol Motil 30:e13383
Tirumanisetty, P; Prichard, D; Fletcher, J G et al. (2018) Normal values for assessment of anal sphincter morphology, anorectal motion, and pelvic organ prolapse with MRI in healthy women. Neurogastroenterol Motil 30:e13314
Chakraborty, Subhankar; Feuerhak, Kelly; Muthyala, Anjani et al. (2018) Effects of Alfuzosin, an ?1-Adrenergic Antagonist, on Anal Pressures and Bowel Habits in Women With and Without Defecatory Disorders. Clin Gastroenterol Hepatol :
Carrington, Emma V; Scott, S Mark; Bharucha, Adil et al. (2018) Expert consensus document: Advances in the evaluation of anorectal function. Nat Rev Gastroenterol Hepatol 15:309-323
Bharucha, Adil E; Sharma, Mayank (2018) Painful and Painless Constipation: All Roads Lead to (A Change in) Rome. Dig Dis Sci 63:1671-1674
Wolf, P G; Parthasarathy, G; Chen, J et al. (2017) Assessing the colonic microbiome, hydrogenogenic and hydrogenotrophic genes, transit and breath methane in constipation. Neurogastroenterol Motil 29:1-9
Prichard, David O; Lee, Taehee; Parthasarathy, Gopanandan et al. (2017) High-resolution Anorectal Manometry for Identifying Defecatory Disorders and Rectal Structural Abnormalities in Women. Clin Gastroenterol Hepatol 15:412-420
Chakraborty, S; Feuerhak, K J; Zinsmeister, A R et al. (2017) Reproducibility of high-definition (3D) manometry and its agreement with high-resolution (2D) manometry in women with fecal incontinence. Neurogastroenterol Motil 29:

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