便通

WordNet

something curved in shape (同)arc
play on a string instrument with a bow
a knot with two loops and loose ends; used to tie shoelaces (同)bowknot
front part of a vessel or aircraft; "he pointed the bow of the boat toward the finish line" (同)fore, prow, stem
a decorative interlacing of ribbons
a slightly curved piece of resilient wood with taut horsehair strands; used in playing certain stringed instruments
a stroke with a curved piece of wood with taut horsehair strands that is used in playing stringed instruments
a weapon for shooting arrows, composed of a curved piece of resilient wood with a taut cord to propel the arrow
bending the head or body or knee as a sign of reverence or submission or shame or greeting (同)bowing, obeisance
an appearance by actors or performers at the end of the concert or play in order to acknowledge the applause of the audience (同)curtain_call
bend ones knee or body, or lower ones head; "He bowed before the King"; "She bowed her head in shame" (同)bow down
bend the head or the upper part of the body in a gesture of respect or greeting; "He bowed before the King"
the act of changing the location of something; "the movement of cargo onto the vessel"
the driving and regulating parts of a mechanism (as of a watch or clock); "it was an expensive watch with a diamond movement"
a natural event that involves a change in the position or location of something (同)motion
a group of people with a common ideology who try together to achieve certain general goals; "he was a charter member of the movement"; "politicians have to respect a mass movement"; "he led the national liberation front" (同)social movement, front
a major self-contained part of a symphony or sonata; "the second movement is slow and melodic"
the center of the Earth

PrepTutorEJDIC

『弓』 / (楽器の)弓 / 弓形,弓形のもの(にじなど) / (リボンなどの)ちょう結び;ちょうネクタイ(bowtie) / (めがねの)つる / 〈バイオリンなど〉'を'弓でひく
(…に)『身をかがめる』,頭をさげる,おじぎをする《+『down』『to』+『名』》 / (…に)屈服する,従う《+『to』+『名』》 / 〈ひざ・腰〉'を'かがめる,(頭など)'を'さげる / …'を'曲げる / 〈感謝など〉'を'おじぎをして示す / …'を'身をかがめて案内する / おじぎ,えしゃく
《時に複数形で;単数扱い》(ボート・船・飛行機の)『先端部』;へさき,機取 / ベートの最前部のオール;そのこぎ手
〈U〉(…の)『運動』,『動き』;移動《+『of』+『名』》 / 〈C〉動作,身振り / 〈C〉《複数形で》行動,活動 / 〈C〉(…に向かう)(事熊の)成り行き,動向《+『toward』+『名』》 / 〈C〉(目標を達成するための一群の人たちの)運動 / 〈C〉(賛団の)移動,移住;(人口の)異動《+『of』+『名』》 / 〈C〉楽章 / 〈C〉(時計などの)機械装置,動く仕掛け
〈C〉『腸』;《通例複数形で》腹わた,内臓 / 《複数形で》内部,中心部

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/07 21:25:12」(JST)

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Anatomy of the anus and rectum

Defecation is the final act of digestion, by which organisms eliminate solid, semisolid, and/or liquid waste material from the digestive tract via the anus.

Humans expel feces with a frequency varying from a few times daily to a few times weekly.^[1] Waves of muscular contraction (known as peristalsis) in the walls of the colon move fecal matter through the digestive tract towards the rectum. Undigested food may also be expelled this way, in a process called egestion.

Open defecation is the practice of defecating outside or in public, i.e. without using a toilet of any kind, mostly due to extreme poverty in developing countries.

Description

Physiology

The rectum ampulla (anatomically also: ampulla recti) temporarily stores fecal waste. As the waste fills the rectum and expands the rectal walls, nervous system stretch receptors in the rectal walls stimulate the desire to defecate. This urge to defecate arises from the reflex contraction of rectal muscles, relaxation of the internal anal sphincter, and an initial contraction of the skeletal muscle of the external anal sphincter. If the urge is not acted upon, the material in the rectum is often returned to the colon by reverse peristalsis, where more water is absorbed and the faeces is stored until the next mass peristaltic movement of the transverse and descending colon. If defecation is delayed for a prolonged period the fecal matter may harden, resulting in constipation. If defecation occurs too fast, before excess liquid is absorbed, diarrhea may occur.^[2]

When the rectum is full, an increase in intra-rectal pressure forces apart the walls of the anal canal, allowing the fecal matter to enter the canal. The rectum shortens as material is forced into the anal canal and peristaltic waves push the feces out of the rectum. The internal and external anal sphincters along with the puborectalis muscle allow the feces to be passed by muscles pulling the anus up over the exiting feces.^{[citation needed]}

Defecation is normally assisted by taking a deep breath and trying to expel this air against a closed glottis (Valsalva maneuver). This contraction of expiratory chest muscles, diaphragm, abdominal wall muscles, and pelvic diaphragm exerts pressure on the digestive tract. Ventilation at this point temporarily ceases as the lungs push the chest diaphragm down to exert the pressure. Thoracic blood pressure rises and as a reflex response the amount of blood pumped by the heart decreases. Death has been known to occur in cases where defecation causes the blood pressure to rise enough to cause the rupture of an aneurysm or to dislodge blood clots (see thrombosis). Also, in releasing the Valsalva maneuver blood pressure falls; this, coupled with standing up quickly to leave the toilet, can result in a blackout.^{[citation needed]} ^[3]

When defecating, the external sphincter muscles relax. The anal and urethral sphincter muscles are closely linked. Experiments by Dr. Harrison Weed at the Ohio State University Medical Center have shown they can only be contracted together, not individually, and that both show relaxation during urination^{[citation needed]}. This explains why defecation is frequently accompanied by urination.

Voluntary and involuntary control

Defecation may be involuntary or under voluntary control. Young children learn voluntary control through the process of toilet training. Once trained, loss of control called fecal incontinence, may be caused by physical injury, nerve injury, prior surgeries (such as an episiotomy), constipation, diarrhea, loss of storage capacity in the rectum, intense fright, inflammatory bowel disease, psychological or neurological factors, or death.^[4]

Anal cleansing

The anus and buttocks may be cleansed after defecation with toilet paper, similar paper products, or other absorbent material. In many cultures, e.g. in Muslim culture, water is used for anal cleansing, either in addition or exclusively.

Posture

The positions and modalities of defecation are culture-dependent. The natural and instinctive method used by all primates, including humans, is the squatting position. Squat toilets are still used by the vast majority of the world, including most of Africa, Asia and the Middle East.^[5] The widespread use of sit-down toilets in the Western world is a recent development, beginning in the 19th century with the advent of indoor plumbing.^[6]

Bockus' Gastroenterology, the standard textbook on the subject, states: "The ideal posture for defecation is the squatting position, with the thighs flexed upon the abdomen. In this way the capacity of the abdominal cavity is greatly diminished and intra-abdominal pressure increased, thus encouraging the expulsion of the fecal mass."^[7]

Society and culture

Mythology and tradition

The caganer is a defecating figurine in Spanish Nativity scenes

Some peoples have culturally significant stories in which defecation plays a role. In a Wemale and Alune legend from the island of Seram, Maluku Province, Indonesia, the mythical girl Hainuwele defecates valuable objects.^[8] One of the traditions of Catalonia (Spain) relates to the Caganer, a figurine depicted in the act of defecation appearing in nativity scenes in Catalonia and neighbouring areas with Catalan culture. The exact origin of the Caganer is lost, but the tradition has existed since at least the 18th century.^[9]

References

^ "A description of Normal Bowel Movements". 30 September 2013. Retrieved 29 November 2013.
^ NIH. "Bowel Movement". Medline. Retrieved 13 September 2014.
^ [Cardio-vascular Events at Defecation: Are They Unavoidable? - Medical Hypotheses, Jul 1990, 32(3):231-3]
^ "Fecal incontinence - Causes". Mayo Foundation for Medical Education and Research. Retrieved 9 September 2014. |first1= missing |last1= in Authors list (help)
^ Kira A. The Bathroom. Harmondsworth: Penguin, 1976, revised edition, pp.115,116.
^ A History of Technology, Vol.IV: The Industrial Revolution, 1750-1850. (C. Singer, E Holmyard, A Hall, T. Williams eds) Oxford Clarendon Press, pps. 507-508, 1958
^ Bockus (1964). Gastroenterology (2nd ed.). Philadelphia and London: Saunders. p. 754.
^ The Oxford Companion to World Mythology - Hainuwele
^ "A traditional Nativity scene, Catalan-style". BBC News. 23 December 2010. Retrieved 23 December 2010.

UpToDate Contents

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1. 乳児および小児における便秘：評価 constipation in infants and children evaluation
2. 成人における過敏性腸症候群の臨床症状および診断 clinical manifestations and diagnosis of irritable bowel syndrome in adults
3. 乳児および小児の機能性便秘：臨床的特徴と鑑別診断 functional constipation in infants and children clinical features and differential diagnosis
4. 高齢者における便秘 constipation in the older adult
5. 術後イレウス postoperative ileus

English Journal

Constipation: understanding mechanisms and management.

Costilla VC, Foxx-Orenstein AE.Author information Department of Internal Medicine, Mayo Clinic in Arizona, Scottsdale, AZ, USA.AbstractConstipation is a frequently diagnosed gastrointestinal disorder. Symptoms of constipation are common, with the greatest prevalence in the elderly. Evaluation of constipation begins with a detailed medical history and a focused anorectal examination. Diagnostic testing for constipation is not routinely recommended in the initial evaluation in the absence of alarm signs. Key self-management strategies include increased exercise, a high-fiber diet, and toilet training. High-fiber diets can worsen symptoms in some patients who have chronic constipation. Biofeedback is an effective treatment option for patients who have constipation caused by outlet obstruction defecation. A variety of medications are available to remedy constipation.
Clinics in geriatric medicine.Clin Geriatr Med.2014 Feb;30(1):107-15. doi: 10.1016/j.cger.2013.10.001.
Constipation is a frequently diagnosed gastrointestinal disorder. Symptoms of constipation are common, with the greatest prevalence in the elderly. Evaluation of constipation begins with a detailed medical history and a focused anorectal examination. Diagnostic testing for constipation is not routin
PMID 24267606

Anorectal physiology and pathophysiology in the elderly.

Yu SW, Rao SS.Author information Division of Gastroenterology and Hepatology, Medical College of Georgia, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA.AbstractAnorectal medical disorders facing the elderly include fecal incontinence, fecal impaction with overflow fecal incontinence, chronic constipation, dyssynergic defecation, hemorrhoids, anal fissure, and pelvic floor disorders. This article discusses the latest advances in age-related changes in morphology and function of anal sphincter, changes in cellular and molecular biology, alterations in neurotransmitters and reflexes, and their impact on functional changes of the anorectum in the elderly. These biophysiologic changes have implications for the pathophysiology of anorectal disorders. A clear understanding and working knowledge of the functional anatomy and pathophysiology will enable appropriate diagnosis and treatment of these disorders.
Clinics in geriatric medicine.Clin Geriatr Med.2014 Feb;30(1):95-106. doi: 10.1016/j.cger.2013.10.003.
Anorectal medical disorders facing the elderly include fecal incontinence, fecal impaction with overflow fecal incontinence, chronic constipation, dyssynergic defecation, hemorrhoids, anal fissure, and pelvic floor disorders. This article discusses the latest advances in age-related changes in morph
PMID 24267605

The effect of two different Individually Ventilated Cage systems on anxiety-related behaviour and welfare in two strains of laboratory mouse.

Burman O, Buccarello L, Redaelli V, Cervo L.Author information School of Life Sciences, University of Lincoln, Brayford, Lincoln, UK.AbstractThe environment in which a laboratory animal is housed can significantly influence its behaviour and welfare, acting as a potential confounding factor for those studies in which it is utilised. This study investigated the impact of two Individually Ventilated Cage (IVC) housing systems on anxiety-related behaviour and welfare indicators in two common strains of laboratory mice. Subjects were juvenile female C57BL/6J and BALB/c mice (N=128) housed in groups of four in two different IVC systems for 7weeks. System One had air delivery at the cage 'cover' level at 75 ACH (Air Changes/Hour) and System Two had air delivery at the 'animal' level at 50 ACH. Mice were assessed twice a week (e.g. bodyweight) or at the end of the study (e.g. anxiety tests). Our results showed significant differences in anxiety-related behaviour between strains and housing systems. Mice in System Two, regardless of strain, defecated more in the Elevated Plus Maze (EPM), spent less time in the open arms of the EPM, and less time in the central zone of the Open Field (OF). Strain differences in anxiety-like behaviour were seen in the increased defecation by BALB/c mice in the OF and EPM and less time spent in the open arms of the EPM compared to C57BL/6J mice. These results suggest that different IVC housing systems can influence mouse behaviour in different ways, with mice of both strains studied exhibiting more anxiety-related behaviour when housed in System Two (air entry at the 'animal' level at 50 ACH), which could impact upon experimental data.
Physiology & behavior.Physiol Behav.2014 Jan 30;124:92-9. doi: 10.1016/j.physbeh.2013.10.019. Epub 2013 Oct 31.
The environment in which a laboratory animal is housed can significantly influence its behaviour and welfare, acting as a potential confounding factor for those studies in which it is utilised. This study investigated the impact of two Individually Ventilated Cage (IVC) housing systems on anxiety-re
PMID 24184492

Japanese Journal

4週間の排便記録による排便パターンの実態調査

加藤京里,菱沼典子,田上恭子他
日本看護技術学会誌 11(2), 28-37, 2012-08-00
NAID 40019428517

Irregular bowel movement in gastrectomized subjects : bowel habits, stool characteristics, fecal flora, and metabolites

Aoki Teruaki,Yamaji Ichiro,Hisamoto Tsuyoshi 他
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 15(4), 396-404, 2012-00-00
NAID 40019463649

A case of referred pain in end-stage primary generalized amyloid light-chain amyloidosis effectively treated by ketamine

梶野友世,柳田京子,吉田憲生,滝本典夫,榊原隆志,牧野雅子,高木麻利名,三浦政直,中村不二雄
Palliative Care Research 7(2), 581-584, 2012
… Bowel movement and large amounts of peritoneal dialysis fluid triggered excessive traction of the glans penis, which caused the excruciating pain. …
NAID 130003327944