Research Article
Volume 9 Issue 2 - 2021
Cortical Processing of Tonic Ano-Rectal Distensions in Patients with Idiopathic Faecal Incontinence
Rasmus Bach Nedergaard1,2,3, Susanne Haas3,4, Peter Christensen3,5, Klaus Krogh3,6, Søren Laurberg3,7, Christina Brock1,2 and Asbjørn Mohr Drewes1,2,3*
1Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
2Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
3Danish Cancer Society Centre for Research and Late Adverse Effects After Cancer in the Pelvic Organs, Aarhus and Aalborg University Hospitals, Aalborg, Denmark
4Department of Surgery, Aarhus University Hospital, Denmark
5Pelvic Floor Unit, Department of Surgery, Aarhus University Hospital, Aarhus N, Denmark
6Neurogastroenterology Unit, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
7Department of Surgery, Section of Coloproctology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
*Corresponding Author: Asbjørn Mohr Drewes, Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
Received: December 07, 2021; Published: January 28, 2022


Aim: The purpose of this study was to investigate the ano-rectal cerebral axis in patients with idiopathic fecal incontinence during sustained distensions in the rectum and in the anal canal.

Methods: 20 women with idiopathic fecal incontinence and 20 healthy age matched women were included. Ano-rectal function was assessed using standard anal manometry together with the sensory response to tonic ano-rectal distension. Cortical electroencephalographic signals were recorded at rest and during 1 minute sustained balloon distension at the urge to defecate threshold in both the anal canal and rectum. Spectral power analysis of the signal during the distension was computed with wavelet analysis, and the coefficients were divided into predefined frequency bands: delta (1 - 4Hz), theta (4 - 8Hz), alpha (8 - 12Hz), beta (12 - 32Hz) and gamma (32 - 70Hz). 

Results: Compared to controls, idiopathic fecal incontinence patients had lower anal resting- (- 48 cm H2O, p < 0.001) and squeeze-pressures (-103 cm H2O, p < 0.001). Further, idiopathic fecal incontinence patients had lower thresholds for first sensation of urge (- 36 ml, p = 0.005) and tolerated decreased maximum volume in rectum (- 89 ml, p = 0.002). There were no differences between idiopathic fecal incontinence patients and healthy controls in any spectral recordings, neither at rest or during ano-rectal distensions. 

Conclusion: In this study patients with idiopathic fecal incontinence and healthy controls exhibited similar cortical processing at rest and during sustained balloon distension of the ano-rectum, decreased sensory threshold to maximum tolerable volume in the rectum for the idiopathic fecal incontinence patients.


Keywords: Electroencephalography, Manometry, Sustained Distension, Wavelet-Analysis


  1. Thomas TM., et al. “The prevalence of faecal and double incontinence”. Journal of Public Health3 (1984): 216-220.
  2. Aitola P., et al. “Prevalence of faecal incontinence in adults aged 30 years or more in general population”. Color Dis7 (2009): 687-691.
  3. Drossman DA. “The Functional Gastrointestinal Disorders and the Rome III Process”. Gastroenterology5 (2006): 1377-1390.
  4. Bharucha AE. “Pelvic floor: anatomy and function”. Neurogastroenterology and Motility7 (2006): 507-519.
  5. Haas S., et al. “Abnormal neuronal response to rectal and anal stimuli in patients with idiopathic fecal incontinence”. Neurogastroenterology and Motility7 (2015): 954-962.
  6. Vernava AM., et al. “Pudendal neuropathy and the importance of EMG evaluation of fecal incontinence”. Diseases of the Colon and Rectum1 (1993): 23-27.
  7. Kiff ES and Swash M. “Slowed conduction in the pudendal nerves in idiopathic (neurogenic) faecal incontinence”. British Journal of Surgery8 (1984): 614-616.
  8. Jiang W., et al. “First-in-man”: Characterising the mechanosensitivity of human colonic afferents”. Gut2 (2011): 281-282.
  9. Collet L., et al. “Cerebral evoked potentials after endorectal mechanical stimulation in humans”. The American Journal of Physiology-Gastrointestinal and Liver Physiology4 (1988).
  10. Ryhammer AM., et al. “Test-retest repeatability of anorectal physiology tests in healthy volunteers”. Diseases of the Colon and Rectum3 (1997): 287-292.
  11. Nissen TD., et al. “Translational aspects of rectal evoked potentials: A comparative study in rats and humans”. The American Journal of Physiology-Gastrointestinal and Liver Physiology2 (2013).
  12. Speakman CT and Kamm MA. “Abnormal visceral autonomic innervation in neurogenic faecal incontinence”. Gut2 (1993): 215-221.
  13. Gram M., et al. “Dynamic spectral indices of the electroencephalogram provide new insights into tonic pain”. Clinical Neurophysiology4 (2015): 763-771.
Citation: Asbjørn Mohr Drewes., et al. “Cortical Processing of Tonic Ano-Rectal Distensions in Patients with Idiopathic Faecal Incontinence”. EC Gastroenterology and Digestive System 9.2 (2021): 08-13.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

December Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 23, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.