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[Women with chronic constipation: clinical examination is more important than anorectal function testing]
Tze J Lam1, Richelle J F Felt-Bersma
1VU Medisch Centrum, afd. Maag-, Darm- en Leverziekten, Amsterdam, the Netherlands. tj.lam@vumc.nl
Nederlands Tijdschrift Voor Geneeskunde
|February 22, 2013
Summary
Physical examination, including rectal and vaginal exams, can identify treatable pelvic floor issues in 40% of women with chronic constipation. Anorectal function testing offers limited additional value for these patients.
Area of Science:
- Gastroenterology
- Pelvic Floor Disorders
Context:
- Chronic constipation affects many women and elderly individuals.
- Physical examination is crucial for diagnosis.
Purpose:
- To evaluate the diagnostic value of physical examination versus anorectal function testing in women with chronic constipation.
Summary:
- Physical examination, including rectal and vaginal exams, identified rectocele or pelvic floor hypertonia in 40% of women.
- Anorectal manometry and endosonography provided minimal additional diagnostic information.
- Anorectal function testing is recommended only for select cases.
Impact:
- Highlights the importance of thorough physical examination for diagnosing treatable causes of chronic constipation.
- Suggests a more conservative approach to specialized testing, potentially reducing healthcare costs and patient burden.
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