Bowel dysfunction

Question 1

Anismus

Answer 1

The failure of complete relaxation of pelvic floor muscles during attempted defecation

Question 2

Proctalgia Fugax

Answer 2

Anal pain usually caused by intense muscle spasms in or around the canal of the anus

Question 3

Peristalsis

Answer 3

Involuntary constriction and relaxation of the muscles of the intestines or other canal, creating wave like movements that push the contents of the canal forward

Question 4

Gastrocolic reflex

Answer 4

Controls motility

Responds to eating–stretch in stomach

Responsible for urge to defecate

Question 5

Sampling response

Answer 5

Sample of stool/air taken at anorectal junction–brain tells body consistency

(30 mL volume)

Question 6

Accommodation reflex

Answer 6

Increased EAS tone–signals to rectum stretch receptors and repressed the urge to defecate

Question 7

Parasympathetic reflex

Answer 7

Total evacuation of stool

Question 8

Intrinsic defection reflex

Answer 8

Relaxation of IAS with rectal filling

Question 9

Rectoanal inhibitory reflex

Answer 9

Relaxation of IAS with rectal filling

Allows for release of air while holding in stool

Question 10

Dovetail

Answer 10

Loss of sphincteric folds common without 3rd degree tears

Question 11

EAS contraction time to suppress urge

Answer 11

60-90 sec

Question 12

Normal defecation urges

Answer 12

Rectal sensation (25-35 mL)

First urge (100-150 mL)

Max tolerance (200-300 mL)

Question 13

Normal anorectal angle

Answer 13

80-100 deg

Question 14

Transit time through small intestines

Answer 14

4-6 hours

Question 15

Transit time through colon

Answer 15

24 hours

Question 16

Transit time from transverse to rectum (through sigmoid)

Answer 16

5 minutes

Question 17

Hirschsprung’s Disease

Answer 17

Hereditary disease–infancy

Large intestines lack nerve cells that innervate the musculature to move stool through the colon

Question 18

Sinus pilonidalis

Answer 18

Small hole or tunnel–often form around hair follicle, may become infected

Question 19

Spinal level rectum begins

Answer 19

S3, 12 cm long

Question 20

Anal canal

Answer 20

3-6 cm long

Sensitive to stretch only above pectinate line

Sensitive to pain, touch, and temperature below

Question 21

Only FDA approved drug for IBS-C

Answer 21

Tegaserod

Question 22

Loperamide

Answer 22

Drug for diarrhea

Not effective for IBS, abdominal pain, bloating, or altered bowel habits

Question 23

Rome 4 IBS

Answer 23

Lasts 3 mo with onset at least 6 mo prior

2 of the following:

• related to defecation
• associated with change in frequency
• associated with change in form