Current techniques of assessing defecation dynamics

Digestive Diseases
S S Rao, W M Sun

Abstract

The pathophysiology of defecation disorders is multifactorial. An ideal test should identify the underlying cause(s) and provide guidelines for treatment. Unfortunately, there is no such single test. But several techniques are available that could provide comprehensive information regarding the changes in defecation dynamics. Among these, anorectal manometry offers the most useful test for clinicians. Manometry may provide objective evidence for impaired rectal sensation, poor rectoanal coordination, weak anal sphincters or changes that support a diagnosis of obstructive defecation. Other tests such as the balloon expulsion test may serve as screening tools for patients with constipation. In a patient with fecal incontinence, anal endosonography may localize the sphincter defect and aid surgical reconstruction. The pudendal nerve latency test may provide a pathophysiological basis for a weak anal sphincter. Imaging techniques such as defecography may provide useful information regarding rectal prolapse or levator ani dysfunction. Ideally, the clinician should utilize these tests either to confirm a clinical suspicion or to provide new information that could aid management. This review provides an update regarding the various te...Continue Reading

Citations

Sep 10, 2003·Current Gastroenterology Reports·Anjana Kumar, Satish S C Rao
Jun 8, 2001·Gastroenterology Clinics of North America·W M Sun, S S Rao
Jun 8, 2001·Gastroenterology Clinics of North America·S S Rao
Feb 1, 2005·Clinics in Colon and Rectal Surgery·Harry T Papaconstantinou
Jan 28, 1999·Obstetrics and Gynecology Clinics of North America·K W Coates
Jul 16, 2003·Gastroenterology Clinics of North America·Satish S C Rao
Mar 23, 1999·The American Journal of Gastroenterology·S S RaoJ L Conklin
Mar 8, 2017·Journal of Clinical Gastroenterology·Alexandra GuillaumeBani Chander Roland
Aug 17, 2004·The American Journal of Gastroenterology·Satish S C Rao, UNKNOWN American College of Gastroenterology Practice Parameters Committee
Aug 21, 2009·Neurourology and Urodynamics·Peter F W M RosierUNKNOWN International Consultation on Incontinence 2008 Committee on Dynamic Testing
Apr 15, 2004·Alimentary Pharmacology & Therapeutics·A K Tuteja, S S C Rao

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