ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2022
Abdomino-anal Dyscoordination in Defecatory Disorders.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 12 citations in OpenAlex.
- Inadequate Propulsion and Pelvic Floor Relaxation in Dyssynergic Defecation: Insights From Synchronous Proctomanometry.Gastroenterology · 2025Article
- Association of obesity-related anthropometric indicators with chronic constipation and diarrhea among U.S. adults: a cross-sectional study.Frontiers in nutrition · 2025Article
- Defecatory disorders are a common cause of chronic constipation in Parkinson disease.Neurogastroenterology and motility · 2024Article
- Comparison of Anorectal Manometry, Rectal Balloon Expulsion Test, and Defecography for Diagnosing Defecatory Disorders.Gastroenterology · 2022Article
- Reproducibility of high-resolution manometry among healthy and constipated persons.Neurogastroenterology and motility · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsThe contribution of the abdominal muscles to normal defecation and disturbances thereof in defecatory disorders (DDs) are unknown.
methodsIn 30 healthy and 60 constipated women with normal rectal balloon expulsion time (BET) (n = 26) or prolonged BET (ie, DD; n = 34), seated anorectal pressures (manometry) and thickness (ultrasound) of the external and internal oblique and transversus abdominis muscles were measured simultaneously at rest, during hollowing, squeeze, evacuation, and a Valsalva maneuver.
resultsCompared with healthy women with a normal BET, DD women had a lower rectal and greater anal pressure increase during evacuation (P ≤ .05), and more activation of the internal oblique and the transversus abdominis muscles during squeeze (P < .05). The change in transversus abdominis thickness during a Valsalva maneuver vs hollowing (rho = 0.5; P = .002) and separately vs evacuation (rho = 0.7; P < .0001) were correlated in DD but not in healthy women with a normal BET. A principal component (PC) analysis of anorectal pressures and muscle thicknesses during evacuation uncovered a PC (PC3) that was associated with a prolonged BET. Higher PC3 scores were associated with low rectal and high anal pressures at rest and during evacuation, thinner external oblique muscle, and thicker internal oblique muscle during evacuation. A greater PC3 score was associated with increased odds for DD vs health (odds ratio, 1.84; 95% CI, 1.05-3.23), and separately vs constipation with a normal BET (odds ratio, 3.64; 95% CI, 1.73-7.69).
conclusionsTaken together, these findings show 3, possibly inter-related, disturbances suggestive of dyscoordination in DD: aberrant activation of abdominal muscles during squeeze in DD, dyscoordination of the abdominal muscles during various tasks in constipated women, and abdomino-anal dyscoordination.
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