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Physiology · Gastrointestinal: rectoanal inhibitory reflex
Sample itemA newborn has delayed passage of meconium and a contracted distal segment on contrast enema. Anorectal manometry shows that rectal distension no longer causes the internal anal sphincter to relax. Which reflex is absent?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Rectoanal inhibitory reflex
Rectal distension normally triggers a myenteric reflex that relaxes the internal anal sphincter. In Hirschsprung disease the distal bowel lacks ganglion cells, so this reflex is absent and the segment remains contracted.
Option by option
A. Rectoanal inhibitory reflex (correct)
Correct. The rectoanal inhibitory reflex needs intact myenteric ganglia, which are missing in Hirschsprung disease.
B. Enterogastric reflex
The enterogastric reflex slows gastric emptying when acid or fat enters the duodenum.
C. Peristaltic reflex
The peristaltic reflex is the local propulsive reflex of the gut wall, not the sphincter relaxation.
D. Gastrocolic reflex
The gastrocolic reflex increases colonic motility after a meal.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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