Evidence map›Paper›PMID 29856103›Full record

Trial reportNeurogastroenterology and motility2018

A pharmacological challenge predicts reversible rectal sensorimotor dysfunctions in women with fecal incontinence.

M Sharma, K Feuerhak, A R Zinsmeister, A E Bharucha

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Neurogastroenterology and motility, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Faecal incontinence in adults.Nature reviews. Disease primers · 2022
    Review
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

M SharmaDivision of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
K FeuerhakDivision of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
A R ZinsmeisterDivision of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
A E BharuchaDivision of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-7644-0390
Mayo Clinic in Arizona · USMayo Clinic in Florida · US

Funding

MAYO CLINIC CENTER FOR TRANSLATIONAL SCIENCE ACTIVITIESUL1RR024150 · NCRR · MAYO CLINIC ROCHESTER · PI RIZZA, ROBERT A. · 2006 to 2011
$66.4M
Pathophysiology of Anorectal DisordersR01DK078924 · NIDDK · MAYO CLINIC ROCHESTER · PI BHARUCHA, ADIL E. · 2008 to 2023
$5.0M
NCRR NIH HHS UL1 RR024150NIDDK NIH HHS R01 DK078924NIH HHS R01 DK78924
6 · The paper itself

Abstract

backgroundIn order to understand the pathophysiology of rectal sensorimotor dysfunctions in women with fecal incontinence (FI) and rectal urgency, we evaluated the effects of a muscarinic antagonist and an adrenergic α

methodsFirstly, rectal distensibility and sensation were evaluated with a barostat and sinusoidal oscillation at baseline and after randomization to intravenous saline or atropine in 16 healthy controls and 44 FI patients. Thereafter, FI patients were randomized to placebo or clonidine for 4 wk; rectal compliance and sensation were revaluated thereafter. The effect of atropine and clonidine on rectal functions and the relationship between them were evaluated.

resultsAt baseline, compared to controls, rectal capacity was lower (P = .03) while the mean pressure (P = .02) and elastance (P = .01) during sinusoidal oscillation were greater, signifying reduced distensibility, in FI. Compared to placebo, atropine increased (P ≤ .02) the heart rate in controls and FI and reduced (P = .03) the variability in rectal pressures during sinusoidal oscillation in controls. Clonidine increased rectal compliance (P = .04) and reduced rectal capacity (P = .03) in FI. The effects of atropine and clonidine on compliance (r = .44, P = .003), capacity (r = .34, P = .02), pressures during sinusoidal oscillation (r = .3, P = .057), pressure (r = .6, P < .0001), and volume sensory thresholds (r = .48, P = .003) were correlated.

conclusionsThe effects of atropine and clonidine on rectal distensibility and sensation were significantly correlated. A preserved response to atropine suggests that reduced rectal distensibility is partly reversible, mediated by cholinergic mechanisms, and may predict the response to clonidine, providing a pharmacological challenge.

Indexed as

Adrenergic alpha-2 Receptor AgonistsAdultAtropineClonidineDouble-Blind MethodFecal IncontinenceFemaleHumansManometryMiddle AgedMuscarinic AntagonistsMuscle TonusRectumSensory ThresholdsAdrenergic alpha-2 Receptor AgonistsAtropineClonidineMuscarinic Antagonistsatropineclonidinefecal incontinencerectal capacityrectal complianceurgency

Identifiers

PMID29856103
PMCPMC6160337
OpenAlexW2806377418

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.