Loss of anal canal reflex

Introduction The anal canal reflex disappears into a kind of shallow reflection in the human nerve reflex. The person lies flat, and the lower extremity is lifted and straightened. The small needle is crossed in the perineal area, and the external anal sphincter will contract. The afferent nerve is the pudendal nerve, the central nucleus of the posterior horn of the medullary 4 to 5 and the anterior horn of the same segment, and the efferent nerve is the pudendal nerve. The external anal sphincter undergoes bilateral perineal innervation. When one side of the pyramidal tract is damaged or the peripheral nerve is damaged, the anal reflex still exists. When the bilateral pyramidal tract is damaged or the cauda equina is damaged, the anal reflex disappears. Incontinence in the elderly can show that the anal canal reflex disappears.

Cause

Causes:

Normal bowel movements require proper anorectal sensation, and pelvic floor receptors are considered to be very important in detecting the presence of feces in the rectum. Patients with fecal block and overflow fecal incontinence have a reduced rectal sensation, and patients with traumatic and idiopathic fecal incontinence may have abnormalities in the anal canal.

Idiopathic fecal incontinence or neurogenic fecal incontinence is caused by the progressive damage of the pelvic floor striated muscle and the external anal sphincter and the reduction of internal sphincter function.

an examination

Related inspection

Anal reflex anus examination for rectal-anal motor function determination

Clinical manifestations:

Defiant defecation and exhaustion are controlled to varying degrees. Patients with mild incontinence lose control of exhaust and liquid feces, and their undergarments are occasionally soiled. Severe patients have no control over solid feces, which is characterized by the frequent discharge of feces from the anus. If the patient can quickly find the toilet, it can avoid soiling the underwear. Patients with this disease often suffer from quality of life and physical and mental health due to long-term dampness and uncleanness in the perineal perineal area, contaminating underwear and bed sheets.

Clinical examination:

1, physical examination can be seen in the anal perineal area wet and dirty, eczema ulcer scars, perianal skin scar anal relaxation, sometimes visible rectal prolapse.

2, the fingerprint can touch hard feces or tumors, etc., may have anal sphincter relaxation and stretching, and its contractile force is weakened or disappeared.

3, careful examination can accurately determine the location of the contraction weakness and can show the disappearance of anal canal.

Differential diagnosis

Differential diagnosis of disappearance of anal canal reflex:

1, anal relaxation: anal relaxation, contraction of the anal canal sphincter and anorectal ring contraction is not obvious and completely disappeared, if caused by injury, the anus can be scarred and scar tissue, incomplete incontinence when the diagnosis can be sphincter and sphincter contraction The force is weakened. Common in anal incontinence.

2, fecal incontinence: due to anal or nerve damage, can not control the phenomenon of feces and gas discharge. Also known as defecation incontinence or anal incontinence. Those who can't control dry stools and loose stools, say complete incontinence; those who can control dry stools, can't control loose stools and gas, say incomplete incontinence. Defecation is a complex and coordinated reflex action that is performed under the dual control of the visceral autonomic and cerebral central nervous system. Fecal incontinence can occur with resection of the lower rectum, obstruction of nerve reflexes, and loss of anal sphincter tension. The elderly can cause anal incontinence due to atrophy of the anal sphincter. Temporary fecal incontinence can also occur when you are suddenly shocked.

3, anal sphincter rupture: anal external sphincter rupture caused by a variety of factors, strong mechanical impact of the anus trauma, can lead to the rupture of the external anal sphincter, in addition, accidental surgery can also lead to the fracture of the external anal sphincter, making Fecal incontinence. The performance of different degrees of defecation and exhaust control, the loss of control of exhaust and liquid feces in patients with mild incontinence, the occasional soiling of their underwear, the critically ill patients have no control over solid feces, the performance of the anus is frequently discharged Feces, if the patient can quickly find the toilet, you can avoid soiling the pants. Patients with this disease often suffer from quality of life and physical and mental health due to long-term dampness and uncleanness in the perineal perineal area, contaminating underwear and bed sheets. Physical examination showed that the anal perineal area was wet and unclean, eczema ulcer scar, perianal skin scar anal relaxation, and sometimes rectal prolapse. Finger tests can reach hard stools or tumors, etc., and the anal sphincter can relax and stretch, and its contractile force is weakened or disappeared. Careful examination can accurately determine the location of the contraction of the cupping network and can show that the anal canal reflex disappears.

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