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Rectal sensory testing, preferably using the barostat, is indicated for the detection of rectal hyposensitivity or rectal hypersensitivity. With the forced-choice technique, patients are told that the distensions will always occur in one of two intervals, and they are to indicate their responses [ 39 ]. The main limitation of PET is that it requires radioactive compounds and is therefore invasive, repeat studies are problematic, it is expensive and sophisticated, and the equipment is only available in specialized centers. No single neurophysiological test will provide comprehensive information regarding the pathophysiology of anorectal disorders since these disorders are heterogeneous and often multifactorial. These local reflexes are independent of rectal sensation [ 10 ]. The barium enema in constipation.

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Biomechanical measuring systems. Potential disadvantages of post-operative adjuvant radiotherapy after anterior resection for rectal cancer. Papers of special note have been highlighted as.. Specialized afferent nerves may exist that subserve sensations of touch, temperature, tension and friction, but these are incompletely understood [ 15 ]. Evaluation of the sacroanal motor pathway by magnetic and electric stimulation in patients with fecal incontinence. The sensation of rectal distention is most likely transmitted along the S2, S3 and S4 parasympathetic nerves.

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Several novel techniques are evolving that may reveal new information on brain—gut interactions. Noninvasive magnetic stimulation of human motor cortex. Slowed conduction in the pudendal nerves in idiopathic neurogenic faecal incontinence. Specialized afferent nerves may exist that subserve sensations of touch, temperature, tension and friction, but these are incompletely understood [ 15 ].

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Description: Changes in anal canal sensation after childbirth. The anus is 2- to 4-cm long. Neurophysiological evaluation of healthy human anorectal sensation. The internal anal sphincter. These nerve fibers traverse along the pelvic splanchnic nerves and are independent of the pudendal nerve. A normal PNTML does not exclude pudendal neuropathy, because the presence of a few intact nerve fibers can give a normal result, whereas an abnormal latency time is more significant. Rectal sensory testing This test is usually performed by distending the rectum with either an air- or water-filled balloon. In general, pressures are higher in men and younger persons, but there is a considerable overlap in values [ 24 ]. Dyssynergic defecation. In a prospective study, anorectal manometry with sensory testing not only confirmed a clinical impression but also provided new information that was not detected clinically [ 28 ].
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