Halpern, Alfred; Shaftel, Norman; Selman, David; Shaftel, Herbert E.; Kuhn, Paul H.; Samuels, Saul S.; Birch, Herbert G.
October 1960
Angiology;Oct1960 Part 2, Vol. 11 Issue 5, p426
Academic Journal
1. The physiology of defecation is discussed and the contribution of intrathoracic, intraabdominal and intestinal intraluminal pressures to the straining forces of bowel function is explored. 2. Exertion at stool may effect an intraabdominal pressure increase of up to 200 mm Kg and also tends to produce excessive intraluminal and intrathoracic pressures. Various techniques for recording intraluminal pressures are described. 3. The duration and magnitude of elevated intrathoracic pressures during straining episodes in normal and constipated subjects were studied and classified according to the criteria of the Valsalva maneuver. It was found that use of the lied pan (in normal individual) and the presence of constipation markedly increase the frequency, intensity and duration of straining during defecation. More than half of the efforts of the constipated group met the Valsalva criteria, whereas only 12 per cent of the exertions of the normal group fell into this category. 4. The use of a constipation corrective reduced the number of strains exceeding 40 mm Hg from a pretreatment level of 93.9 per cent ot 38.8 per rent, and the incidence of exertions lasting longer than 8 seconds was reduced from 03.3 per cent before therapy to 12.2 per cent after therapy. The use of such agents, therefore, is indicated to reduce the incidence of these stressor effects.


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