Act Of Defecation Research Articles

Acute Pulmonary Embolism Triggered by the Act of Defecation

Pulmonary embolism associated with the act of defecation has not been previously well described. Recently, we reported our experience with four patients who presented to us over a 12-month period with syncope, near syncope, or sudden death following the act of defecation. In all four cases, acute pulmonary embolism was shown to be the etiology of the defecation-associated events. A retrospective chart review of all patients with the diagnosis of pulmonary embolism at our institution over a three-year period yielded five additional patients with the diagnosis of defecation-associated pulmonary embolism. These nine patients accounted for 6.8 percent of all patients with a discharge diagnosis of pulmonary embolism seen at our institution during the three-year study period. Six of the nine patients died from their defecation-associated pulmonary embolism. These six deaths accounted for 25 percent of all deaths from pulmonary embolism seen at our institution during the study period. Based on our experience, we suggest that the act of defecation may trigger the development of acute pulmonary embolism in some patients with deep vein thrombosis.

Psychosomatic aspects of defecation and its disturbances.

Constipation and diarrhea are usually defined in terms of frequency of defecation and consistency of stool. However, the subjective component in these symptoms is so great that the objective criteria cannot be satisfactory. An important additional aspect is provided by the analysis of sensations and postures in the three phases of the act of defecation (announcing, emptying, subsequent phase). Taking account of the subjective aspects may contribute to a better differentiation and classification not only of constipation and diarrhea but also of such disturbances as organic rectal disease and irritable colon.

Anorectal complications of pregnancy: Anatomic and physiologic changes of the anorectum and pelvirectum during pregnancy

1. 1. Anorectal disease in pregnancy is both directly and indirectly affected by specific anopelvirectal changes of pregnancy prenatally, with delivery and with changes of involution postpartum. 2. 2. The relationship of the anorectum and the pelvirectum is shown both anatomically and physiologically to the pelvis and genital organs in the non-pregnant state, during pregnancy and postpartum. This particularly relates to knowledge gained recently of their levator ani components from the levator ani structurely and functionally, and particularly relates to the profuseness of blood supply to the anopelvirectum with its profuse collateral blood supply throughout the pelvis. 3. 3. It has been shown that the work of Courtney on the anatomy of the pelvic diaphragm and anorectal musculature, now applied both anatomically and physiologically, demonstrates that the anorectum cannot be considered as an organ distinctly anorectal, but should be considered as an organ both pelvirectal as well as anorectal and as part of the levator ani. The levator ani assumes a vital part in the act of defecation as well as of childbirth which is anopelvirectal. Here pelvirectally is the area where a profuse blood supply to the rectum occurs. 4. 4. Specific anorectal and pelvirectal changes in pregnancy are outlined. 5. 5. Accompanying mechanical, hormonal and secretory changes affecting the gastrointestinal tract and directly or indirectly affecting specific anopelvirectal changes are outlined. 6. 6. Hemorrhoids and pruritus of anorectal and perigenital type have a high incidence during pregnancy. Other anorectal diseases have a low incidence. 7. 7. A new concept of the etiology of hemorrhoids and a new classification thereof is given. This is based on our knowledge of the profuse collateral blood supply in the pelvis to the ano rectum and pelvirectum and is also based on known accepted facts of the etiology and classification of varicose veins elsewhere than the anorectum. 8. 8. Anorectal disease in pregnancy, other than cancer, ulcerative colitis and postpartum communicating fistulas, such as rectovaginal fistula, are discussed in detail and new concepts of their presence or absence in pregnancy and their management as related to pregnancy changes, and to the pregnancy itself, are considered in each instance.

Blood pressure changes during defecation

The act of defecation is attended by an increase in blood pressure. This increase in blood pressure is greater according as the straining at stool is greater.

THE FORM OF THE STOOL AS A CRITERION OF LAXATION

It has been well established that one of the important functions of the large intestine is to dehydrate the food residues received from the small bowel in preparation for elimination by the act of defecation. Burnett 1 has made this the of a test for what he calls intestinal indigestion and has suggested that the ability to form a hard stool made up of numerous smaller parts called fecal units indicates that the large intestine is in excellent condition; cases were described in which the shape of the stool was changed by dietary means from a soft and formless type to a unit basis with concomitant improvement of health. He also reported on the rate of passage of food residues through the alimentary tract, his method being to study the time required for practically all of a 50 cc. quantity of millet seed to be eliminated. As a result