Chronic constipation (CC) is a common condition that affects up to 25% of the population in
North America. It poses a major burden on the healthcare cost. The pathophysiology of this
condition is poorly understood and consequently there are inadequate treatments. Current
diagnostic tests provide incomplete and often conflicting information. Fecobionics is an
electronic simulated stool that has the consistency and shape of normal stool. The device
records pressures, cross-sectional area, orientation, bending, and shape of the rectum and
anal canal simultaneously. The central hypothesis is that rectal peristalsis is a key
component of the defecatory reflex which is not assessed in the current paradigm of
diagnostic testing. The novel Fecobionics device will mimic the natural defecation and
provide new mechanistic insights into the anorectal physiology and pathophysiology to
facilitate the development of new treatments for CC. The Specific Aims are as follows: 1)
Study the defecation dynamics in normal control subjects using Fecobionics. The investigators
will establish the role of rectal contraction/peristalsis in the normal evacuation process.
2) Define the defecatory patterns in patients with CC associated with defecatory disorders.
The investigators will determine if abnormalities of rectal contraction contribute to the CC.
3) Use a mathematical model of anorectal passage of Fecobionics for enhanced understanding of
the normal and abnormal defecatory patterns, including the length-tension properties of the
rectum and anal sphincter muscles. The proposal seeks to shift current CC research by
providing a stool surrogate for examining the physiologic parameters of defecation reflex
using a novel device that will record, pressure, deformability, biomechanics, vectoral and
topographic changes in the rectum and anal canal. The noted parameters will be recorded using
a wireless Fecobionics device that can examine in detail the mechanistic underpinnings
(stress and deformation) of defecation reflex/process in health and disease. The impact of
this project is that it assesses a novel, safe, low cost, less invasive, low-risk,
radiation-free device in its ability to provide better understanding of evacuation and
continence mechanisms and thereby facilitate future development of innovative therapies. The
improvement can lead to improvement in diagnostic and therapeutic modalities and reduce
healthcare costs associated with anorectal disorders.