Biology:Rectoanal inhibitory reflex
The rectoanal inhibitory reflex (RAIR), also known as the anal sampling mechanism, anal sampling reflex, rectosphincteric reflex, or anorectal sampling reflex, is a reflex characterized by a transient involuntary relaxation of the internal anal sphincter in response to distention of the rectum.[1] The RAIR provides the upper anal canal with the ability to discriminate between flatus and fecal material.
The ability of the rectum to discriminate between gaseous, liquid and solid contents is essential to the ability to voluntarily control defecation. The RAIR allows for voluntary flatulation to occur without also eliminating solid waste, irrespective of the presence of fecal material in the anal canal.[2]
Reflex arc
The physiological basis for the RAIR is poorly understood,[3] but it is thought to involve a coordinated response by the internal anal sphincter to rectal distention with recovery of anal pressure from the distal to the proximal sphincter.[1] Mediated by the autonomic nervous system, the afferent limb of this reflex depends upon an intact network of interstitial cells of Cajal in the internal anal sphincter. These cells, which are mediated at least in part by nitric oxide, provide inhibitory innervation of the internal anal sphincter.[4]
Clinical significance
Impairment of this reflex can result in fecal incontinence.[5][6] The absence of a RAIR is pathognomonic for Hirschsprung's disease.[7]
See also
References
- ↑ 1.0 1.1 "Parameters of the rectoanal inhibitory reflex in patients with idiopathic fecal incontinence and chronic constipation". Diseases of the Colon and Rectum 41 (2): 200–8. February 1998. doi:10.1007/bf02238249. PMID 9556245.
- ↑ "Intestinal Motility". Gastrointestinal Physiology (2nd ed.). New York: Lange Medical Books/McGraw-Hill. 2014. p. 180. ISBN 978-0071774017.
- ↑ "Pathophysiology of adult fecal incontinence". Gastroenterology 126 (1 Suppl 1): S14–22. January 2004. doi:10.1053/j.gastro.2003.10.013. PMID 14978634.
- ↑ "Interstitial cells of Cajal are involved in the afferent limb of the rectoanal inhibitory reflex". Gut 54 (8): 1107–13. August 2005. doi:10.1136/gut.2004.051045. PMID 16009682.
- ↑ "Rectoanal Inhibition". Complex Anorectal Disorders: Investigation and Management. London: Springer Science+Business Media. 2005. p. 39. ISBN 978-1-85233-690-5. http://eknygos.lsmuni.lt/springer/97/39-47.pdf.
- ↑ "The recto-anal inhibitory reflex: abnormal response in diabetics suggests an intrinsic neuroenteropathy". Journal of Gastroenterology and Hepatology 13 (11): 1107–10. November 1998. doi:10.1111/j.1440-1746.1998.tb00584.x. PMID 9870796.
- ↑ "Neurophysiological testing in anorectal disorders". Expert Review of Gastroenterology & Hepatology 2 (3): 323–35. June 2008. doi:10.1586/17474124.2.3.323. PMID 19072383.
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