Esophageal and gastric motile response to rectal distension with identification of a recto-esophagogastric reflex.
OBJECTIVE
To investigate the effect of rectal distension with a balloon simulating fecal mass, on the motile activity of the esophagus and stomach.


METHODS
Nine healthy volunteers (7 men, 2 women, mean age 46.6 +/- 4.7 years) were studied. A manometric tube was introduced into the stomach and a balloon-tipped catheter into the rectum. The gastric and esophageal pressure response to rectal distension in increments of 10 ml up to 80 ml of water was recorded. The test was repeated after rectal anesthetization.


RESULTS
There was no esophageal or gastric pressure response to rectal distension up to 70 ml. At 80 ml distension, the rectal pressure rose (p < 0.001) and the balloon was dispelled to the exterior. Meanwhile, the pressure in the esophagus, corpus of the stomach and pyloric antrum showed a significant drop (p < 0.05) and in the lower esophageal sphincter and pyloric sphincter a significant rise (p < 0.05). There was no esophageal or gastric response to distension of the anesthetized rectum.


CONCLUSIONS
Lower esophageal and pyloric sphincter contraction and esophageal and gastric relaxation during rectal distension appear to delay gastric emptying. The response of the esophagus and stomach to rectal distension seems to be elicited by a reflex which we call "recto-esophagogastric reflex". It is suggested that rectal lesions or dysfunction might disturb the esophageal or gastric motility and vice versa. The reflex may therefore prove to be of significance in the diagnosis of such disorders.
Shafik
A
A
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Egypt. shafisci@link.com.eg
El-Sibai
O
O
D000328:Adult; D002404:Catheterization; D004943:Esophagogastric Junction / Q000502:physiology; D004947:Esophagus / Q000502:physiology*; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis; D011312:Pressure; D011706:Pyloric Antrum / Q000502:physiology; D012007:Rectum / Q000502:physiology*; D012018:Reflex / Q000502:physiology*; D013270:Stomach / Q000502:physiology