78 Oxidative Alcohol Metabolism Sensitizes Pancreas to Mitochondrial Dysfunction Leading to Pancreatitis

Defecation is a complex process. It results from a combination of reflexes from the internal and external sphincters together with puborectalis muscles. When the rectal stimulus is greater and combined with stimulation of the anal canal defecation must takes place. The puborectalis muscles play an important role in controlling the defecation process. It passes directly backward from the back of the pubis with its inner surface in intimate contact with the lateral walls of the vegina or prostat and the anorectal junction. The Functional lumen imaging probe (FLIP) is a cylindrically shaped, liquid filled bag (7.5cm long), mounted on a catheter into the anus. In this work it was positioned straddling the anorectal region in 20 healthy volunteers (10 females). Provocative tests using straining at bag volumes of 20, 30 and 40ml were carried out and data on 16 cross-sectional area measurements at 5mm apart and bag pressure were recorded. Results indicated that the straining pattern depends on gender. For males the straining started with an increase in the pressure in the FLIP bag which is induced by the rectal pressure and then in approximately 3 seconds a relaxation in the puborectalis muscles (the distal part of the anal canal) and external sphincter muscle (proximal part of the anal canal) occurred. In contrast, in females the increase in the pressure in the bag and the relaxation in the anorectal region happened at the same time. The straining pressure for male (53±19mmHg) was higher than female (37±14mmHg).The relaxation in the anal canal during straining in females was small compared to relaxation in males (p<0.001). This may be related the anatomical differences between the sexes, Figure1&2. The three dimensional reconstructed images from straining shows increase in the anorectal angle during straining (defecation). See figure1.By the use of this new technique, further information on the passage of stool as well as the size and consistency can be obtained.