Anal and Rectal Diseases Explained by Eli D., M.D. Ehrenpreis

By Eli D., M.D. Ehrenpreis

Even though rectal and perianal court cases are one of the commonest noticeable by way of fundamental care physicians, surgeons, and gastroenterologists, the big variety of problems linked to those lawsuits are, generally, poorly understood. also, numerous more recent diagnostic resonance imaging, at the moment are being hired for the assessment of those problems. ultimately, new pharmacotherapies, together with immunosuppressants and topical remedies in addition to new surgical remedies, have emerged. those are defined in a transparent, effortless demeanour.

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Complementary procedures Barium enema, stool collection, Hemoccult® fecal blood test, anorectal ultrasound, anorectal manometry, and defecography. Contraindications Imperforate anus. Relative contraindications Severe anal or rectal pain (such as that caused by an anal fissure), anal or rectal stricture, or severe coagulopathy (in which biopsies should not be performed). Preparation of patient The patient should only receive clear liquids after their dinner the night or 16 hours before the procedure and should be given two sodium phosphate enemas on the morning of the procedure.

The procedure involves placement of an electrode (using a needle, wire, or surface plug) onto the anal muscle. The electrical activity of the internal and external anal sphincter and the puborectalis muscles is then measured. Electrical action is measured at rest and during various maneuvers, including squeezing, pushing, and coughing (see Figure 1). The signal is transferred from the record electrode to an amplifier and oscilloscope. Data are converted via a computerized formula. Indications Chronic constipation with suspected obstructive defecation disorders, chronic straining, suspected pelvic neuromuscular disorders, identification of anal sphincter injury, and fecal incontinence.

This is complemented by administration of laxatives, enemas, and/or suppositories. In our practice, patients are encouraged to drink one 8 oz bottle of magnesium citrate at 12:00 (midday) on day 2. This is followed by two bisacodyl tablets at 16:00 and 20:00. Clear liquids are encouraged until 22:00, after which no further intake of food or liquids is allowed. At 06:00 on the day of the study, the patient self-administers one bisacodyl suppository. How the procedure is performed The technician places a catheter into the rectum and barium is injected to fill the colon.

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