n.

清浄化、浄化。脱糞、排便

an 8-year-old boy with a history of constipation and painful defecation presents with fecal soiling.

ex.

defecation reflex 排便反射

WordNet

the elimination of fecal waste through the anus (同)laxation, shitting

PrepTutorEJDIC

脱糞,排便

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/04/02 13:43:43」(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, birth, or death.^[4]

Anal cleansing after defecation

The anus and buttocks may be cleansed after defecation with toilet paper, similar paper products, or other absorbent material. In many cultures, such as Muslim and Hindu cultures, water is used for anal cleansing after defecation, either in addition to using toilet paper or exclusively. When water is used for anal cleansing after defecation, toilet paper may be used for drying the area afterwards.

Posture

The positions and modalities of defecation are culture-dependent. Squat toilets are used by the vast majority of the world, including most of Africa, Asia and the Middle East.^[5] The 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]

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.^[7] 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.^[8]

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
^ 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. 成人における慢性便秘の病因および評価 etiology and evaluation of chronic constipation in adults
2. 高齢者における便秘 constipation in the older adult
3. 成人における便失禁 fecal incontinence in adults
4. 小児における便秘：病因および診断 constipation in children etiology and diagnosis
5. 直腸脱の概要 overview of rectal procidentia rectal prolapse

English Journal

Chronic Constipation: a Review of Current Literature.

Sbahi H1, Cash BD2.
Current gastroenterology reports.Curr Gastroenterol Rep.2015 Dec;17(12):47. doi: 10.1007/s11894-015-0471-z.
Chronic constipation is a common health condition representing a substantial proportion of primary care visits and referrals to specialist providers. Chronic constipation can have a significant negative effect on health-related quality of life and has been associated with psychological distress in s
PMID 26449614

A standardised faecal collection protocol for intestinal helminth egg counts in Asian elephants, Elephas maximus.

Lynsdale CL1, Santos DJ2, Hayward AD3, Mar KU1, Htut W4, Aung HH4, Soe AT4, Lummaa V1.
International journal for parasitology. Parasites and wildlife.Int J Parasitol Parasites Wildl.2015 Jun 30;4(3):307-15. doi: 10.1016/j.ijppaw.2015.06.001. eCollection 2015.
The quantitative assessment of parasite infection is necessary to measure, manage and reduce infection risk in both wild and captive animal populations. Traditional faecal flotation methods which aim to quantify parasite burden, such as the McMaster egg counting technique, are widely used in veterin
PMID 26236632

Assessment of the impacts of traditional Persian medical schemes and recommendations on functional chronic constipation compared to a classic medicine lactulose, a randomized clinical trial.

Emami Alorizi SM, Fattahi MR, Saghebi SA, Salehi A, Rezaeizadeh H, Nimrouzi M, Zarshenas MM.
Journal of complementary & integrative medicine.J Complement Integr Med.2015 Dec 1;12(4):325-31. doi: 10.1515/jcim-2015-0013.
BACKGROUND: To manage chronic constipation, numerous lifestyle modification schemes and recommendations as well as applications of natural medicaments have been mentioned in manuscripts of traditional Persian medicine (TPM). This study was aimed to compare the impacts of some of those recommendation
PMID 26214609

Efficacy of a Chinese Herbal Medicine in Providing Adequate Relief of Constipation-predominant Irritable Bowel Syndrome: A Randomized Controlled Trial.

Bensoussan A1, Kellow JE2, Bourchier SJ3, Fahey P4, Shim L2, Malcolm A2, Boyce P5.
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.Clin Gastroenterol Hepatol.2015 Nov;13(11):1946-1954.e1. doi: 10.1016/j.cgh.2015.06.022. Epub 2015 Jun 29.
BACKGROUND & AIMS: Irritable bowel syndrome (IBS) is the most common chronic functional bowel disorder, with few treatment options. IBS affects 10%-20% of the population; as many as 58% of patients have constipation-predominant IBS (IBS-C). We evaluated efficacy and safety of a standardized, spe
PMID 26133902