ReviewNature reviews. Gastroenterology & hepatology2021
Understanding the physiology of human defaecation and disorders of continence and evacuation.
Review in Nature reviews. Gastroenterology & hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
79 citing papers in PubMed, 2 syntheses or guidelines pooled it, 135 citations in OpenAlex.
- Pooled it
- Post-operative colonic manometry in children with anorectal malformations: A systematic review.Neurogastroenterology and motility · 2022Pooled it
- Constipation as a Hidden Barrier to Pelvic Floor Tele-Rehabilitation: A Randomized Controlled Trial in Women with Stress Urinary Incontinence.International urogynecology journal · 2026Trial
- Dietary Inflammatory Potential and Continence-Related Symptoms: Cross-Sectional and Longitudinal Analyses of Three Population Studies.Food science & nutrition · 2026Article
- Irritable bowel syndrome.Nature reviews. Disease primers · 2026Review
- Thickening of the internal anal sphincter: correlation with external rectal intussusception and associated features at MR proctography and anal manometry.Abdominal radiology (New York) · 2026Article
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- The Utility of the Functional Sphincter Area: A Novel Functional Lumen Imaging Probe Parameter for the Assessment of Anal Sphincter Structure and Function in Fecal Incontinence.Journal of neurogastroenterology and motility · 2026Article
- Sensation of Incomplete Evacuation in Patients With Fecal Incontinence: A Cross-Sectional Study of a Tertiary Referral Cohort.Neurogastroenterology and motility · 2026Article
- Intraoperative neurophysiological monitoring reduces postoperative constipation in unilateral biportal endoscopic lumbar spine surgery.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2026Article
- Exploring brain activity differences in functional constipation using fNIRS: a case-control study.Journal of neuroengineering and rehabilitation · 2026Article
- Preliminary Content Validation and Translation of the Modified Initial Measurement of Patient-Reported Pelvic Floor Complaints Tool Short Form in Kannada.International urogynecology journal · 2026Article
- Arginine protects against colonic barrier injury induced by long-term peritoneal dialysis.Scientific reports · 2026Article
- Role of Ultrasound in the Evaluation of Women with Obstetric Anal Sphincter Injuries: Narrative Review.International urogynecology journal · 2026Review
- Accelerated aging mediates the association between fecal incontinence and mortality: Evidence from the National Health and Nutrition Examination Survey.The Journal of international medical research · 2026Article
- A randomized controlled study on the efficacy and function of internal sphincter lowering combined with external sphincter denudation and virtual hanging drainage in the treatment of complex anal fistula.Frontiers in surgery · 2026Article
- Faster bowel recovery with superior haemorrhoidal artery preservation in patients undergoing sigmoidectomy for diverticular disease: A retrospective cohort study from the diverticular disease registry trial.Journal of minimal access surgery · 2026Article
- Dietary Characteristics Associated With High Defecation Frequency and Constipation in Japanese Adults: A Cross-Sectional Study.JGH open : an open access journal of gastroenterology and hepatology · 2026Article
- An Effective Oral Drug Delivery Route for Pharmacokinetic Complications: Spirulina Lipid Nanotechnology System.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Anorectal gastric heterotopia as a rare cause of constipation: Case report and review of pediatric literature.JPGN reports · 2025Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The act of defaecation, although a ubiquitous human experience, requires the coordinated actions of the anorectum and colon, pelvic floor musculature, and the enteric, peripheral and central nervous systems. Defaecation is best appreciated through the description of four phases, which are, temporally and physiologically, reasonably discrete. However, given the complexity of this process, it is unsurprising that disorders of defaecation are both common and problematic; almost everyone will experience constipation at some time in their life and many will develop faecal incontinence. A detailed understanding of the normal physiology of defaecation and continence is critical to inform management of disorders of defaecation. During the past decade, there have been major advances in the investigative tools used to assess colonic and anorectal function. This Review details the current understanding of defaecation and continence. This includes an overview of the relevant anatomy and physiology, a description of the four phases of defaecation, and factors influencing defaecation (demographics, stool frequency/consistency, psychobehavioural factors, posture, circadian rhythm, dietary intake and medications). A summary of the known pathophysiology of defaecation disorders including constipation, faecal incontinence and irritable bowel syndrome is also included, as well as considerations for further research in this field.
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Registered trials
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.