EFFECTS OF CHOLINERGIC AGENTS ON ANORECTAL PHYSIOLOGY

Citation
L. Siproudhis et al., EFFECTS OF CHOLINERGIC AGENTS ON ANORECTAL PHYSIOLOGY, Alimentary pharmacology & therapeutics, 12(8), 1998, pp. 747-754
Citations number
32
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pharmacology & Pharmacy","Gastroenterology & Hepatology
ISSN journal
0269-2813
Volume
12
Issue
8
Year of publication
1998
Pages
747 - 754
Database
ISI
SICI code
0269-2813(1998)12:8<747:EOCAOA>2.0.ZU;2-K
Abstract
Background: Despite their potential therapeutic benefit, the effects o f cholinergic agents on anal function have been poorly investigated. A im: To analyse the effects of neostigmine and atropine on anorectal re sponses to rectal isobaric distension, Methods: This was a placebo-con trolled, randomized, double-blind crossover study, performed in 12 hea lthy volunteers who received intravenously, on 3 separate days, neosti gmine, atropine or the placebo. During each day of the experiment, sev en pressure steps (ranging from 1 to 31 mmHg) in three different proto cols of rectal isobaric distension (phasic, stepwise and tonic) were a pplied using an electronic barostat, Manometric responses of the anal canal, adaptative volumes and perception scores of the rectum were rec orded. Results: During stepwise distension, a significant drug effect was encountered at the anal level. No drug effect was observed on the other investigated parameters (rectal volumes and rectal perception sc ores) or for the other modes of distension, Compared to placebo, neost igmine significantly decreased pressures at the upper level of the ana l canal for both recto anal inhibitory reflex and mean resting pressur es, In contrast, atropine significantly increased pressures at the low er part of the anal canal but did not modify upper anal pressures, Con clusion: The present study suggests that cholinergic effects result mo re from an indirect action on intermediate neurotransmitters and recta l myenteric neurons, than from a direct action on anal targets.