Hi, I have this condition
I've researched a lot into muscles / nerves to try to explain odor + rectal inertia. These two symptoms are often ''different sides of the same coin''.
http://books.google.co.uk/books?id=DhQ1A35E8jwC&pg=PA43&lpg=PA43&dq=contraction+in+response+to+anorectal+sampling&source=bl&ots=Ck4nWqqp_-&sig=tFTtQcclQ9V2wbbI9U1vECpwyEY&hl=en&sa=X&ei=iOEsUKLPLO6k0AXLjoHgDA&ved=0CDoQ6AEwATgK#v=onepage&q=contraction%20in%20response%20to%20anorectal%20sampling&f=false
the RAIR reflex is the relaxation of IAS (internal sphincter) to allow contents to come down to be sampled (solid, liquid, gas) by receptors. This happens 7 times per day according to some sources or 7 times per hour according to this source http://lup.lub.lu.se/luur/download?func=downloadFile&recordOId=148995&fileOId=625195
It is accompanied by an automatic contraction of the EAS (external sphincter) http://courses.washington.edu/conj/bess/defecation/defecation.html so that continued contraction would maintain continence or choosing not to contract at appropriate time would allow evacuation of stool/ gas.
+ I forgot to bookmark a source which said ''90% of urge is created by the RAIR anorectal sampling reflex'' - rectal distention itself creates only a slight feeling of pressure.
http://www.ncbi.nlm.nih.gov/pubmed/21188800''Effective evacuation requires a fully functional rectoanal inhibitory reflex (RAIR)-mediated relaxation of the IAS via inhibitory neurotransmission (INT)''
Perhaps the inertia could be explained by an impaired RAIR reflex and the odor caused by the final part playing itself out (breaking the seal) at times other than a movement - ordinary continence / evacuation mechanisms jumbled by the impaired RAIR.
Stool building in the rectum perhaps intitiates the partially-functioning RAIR without any urge, and the IAS / EAS then think that they should be relaxing enough to break the seal ... first + final (missing the middle) parts of the reflex happening in between movements??
When searching on google for evacuation problems: pelvic floor dyssynergia, anismus, paradoxical contractions, non relaxing puborectalis etc etc the comments /discussions from patients almost never mention odor.... It might be possible to trade the odor+evacuation problem for just an evacuation problem with neurotransmitter inhibitors /blockers..or snipping a nerve might not be guaranteed to make things worse.
the chemicals which control IAS are thought to be Nitric oxide, VIP and CO,http://www.ncbi.nlm.nih.gov/pubmed/15836455 (i have extra links about this which I'l find if anyone is interested) they're actions can be blocked by other topical chemicals like L'arganine. if it could be effective for a few hours without altering vital functions elsewhere in the body it might be worth considering - it would be the opposite of nitroglycerine for fissures (fissures need relaxation of IAS)
sufferers of fissures take baths to relieve pain because the warm water relaxes the IAS. For our condition, some have mentioned baths usually have a positive effect for 30-60 mins, maybe the IAS relaxation during a bath re-initiates and does what it should until the next time the RAIR occurs? If that was true, then the same effect could be achieved by inhaling isopropanol butynol etc (poppers) these relax smooth muscles around the body including IAS, although it probably wouldnt be good to be sniffing them all the time....
I've researched a lot into muscles / nerves to try to explain odor + rectal inertia. These two symptoms are often ''different sides of the same coin''.
http://books.google.co.uk/books?id=DhQ1A35E8jwC&pg=PA43&lpg=PA43&dq=contraction+in+response+to+anorectal+sampling&source=bl&ots=Ck4nWqqp_-&sig=tFTtQcclQ9V2wbbI9U1vECpwyEY&hl=en&sa=X&ei=iOEsUKLPLO6k0AXLjoHgDA&ved=0CDoQ6AEwATgK#v=onepage&q=contraction%20in%20response%20to%20anorectal%20sampling&f=false
the RAIR reflex is the relaxation of IAS (internal sphincter) to allow contents to come down to be sampled (solid, liquid, gas) by receptors. This happens 7 times per day according to some sources or 7 times per hour according to this source http://lup.lub.lu.se/luur/download?func=downloadFile&recordOId=148995&fileOId=625195
It is accompanied by an automatic contraction of the EAS (external sphincter) http://courses.washington.edu/conj/bess/defecation/defecation.html so that continued contraction would maintain continence or choosing not to contract at appropriate time would allow evacuation of stool/ gas.
+ I forgot to bookmark a source which said ''90% of urge is created by the RAIR anorectal sampling reflex'' - rectal distention itself creates only a slight feeling of pressure.
http://www.ncbi.nlm.nih.gov/pubmed/21188800''Effective evacuation requires a fully functional rectoanal inhibitory reflex (RAIR)-mediated relaxation of the IAS via inhibitory neurotransmission (INT)''
Perhaps the inertia could be explained by an impaired RAIR reflex and the odor caused by the final part playing itself out (breaking the seal) at times other than a movement - ordinary continence / evacuation mechanisms jumbled by the impaired RAIR.
Stool building in the rectum perhaps intitiates the partially-functioning RAIR without any urge, and the IAS / EAS then think that they should be relaxing enough to break the seal ... first + final (missing the middle) parts of the reflex happening in between movements??
When searching on google for evacuation problems: pelvic floor dyssynergia, anismus, paradoxical contractions, non relaxing puborectalis etc etc the comments /discussions from patients almost never mention odor.... It might be possible to trade the odor+evacuation problem for just an evacuation problem with neurotransmitter inhibitors /blockers..or snipping a nerve might not be guaranteed to make things worse.
the chemicals which control IAS are thought to be Nitric oxide, VIP and CO,http://www.ncbi.nlm.nih.gov/pubmed/15836455 (i have extra links about this which I'l find if anyone is interested) they're actions can be blocked by other topical chemicals like L'arganine. if it could be effective for a few hours without altering vital functions elsewhere in the body it might be worth considering - it would be the opposite of nitroglycerine for fissures (fissures need relaxation of IAS)
sufferers of fissures take baths to relieve pain because the warm water relaxes the IAS. For our condition, some have mentioned baths usually have a positive effect for 30-60 mins, maybe the IAS relaxation during a bath re-initiates and does what it should until the next time the RAIR occurs? If that was true, then the same effect could be achieved by inhaling isopropanol butynol etc (poppers) these relax smooth muscles around the body including IAS, although it probably wouldnt be good to be sniffing them all the time....