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Related Concept Videos

Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy01:26

Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy

This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation01:30

Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation

Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Drugs Affecting GI Tract Motility: Bulk-Forming and Stimulant Laxatives01:22

Drugs Affecting GI Tract Motility: Bulk-Forming and Stimulant Laxatives

Laxatives enhance bowel movements and alleviate constipation. They augment the stool's bulk, stimulate intestinal muscle contractions, draw water into the intestines, or soften the stool. There are five key types of laxatives: bulk laxatives, stimulant laxatives, osmotic laxatives, stool softeners, and lubricant laxatives.
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Related Experiment Videos

[Chronic constipation and rectal functional investigations].

Heiko U De Schepper1, Albert J Bredenoord, André J P M Smout

  • 1Academisch Medisch Centrum, afd. Maag-, Darm- en Leverziekten, Amsterdam, the Netherlands.

Nederlands Tijdschrift Voor Geneeskunde
|February 22, 2013
PubMed
Summary

Chronic constipation stems from motility issues or rectal evacuation problems (dyschezia). Accurate diagnosis using clinical exams and functional studies is key for effective treatment selection.

Related Experiment Videos

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Pelvic Floor Disorders

Background:

  • Chronic constipation is a common condition with multiple underlying causes, including disordered colonic motility and impaired rectal evacuation (dyschezia).
  • Identifying the primary mechanism of constipation is crucial for selecting the most effective treatment strategy, differentiating between therapies like laxatives, prokinetics, pelvic floor retraining, or surgery.
  • While digital rectal examination can suggest dyschezia, further confirmation is often necessary for precise diagnosis and management planning.

Purpose of the Study:

  • To emphasize the importance of distinguishing between colonic motility disorders and impaired rectal evacuation (dyschezia) in chronic constipation.
  • To highlight the necessity of complementary diagnostic approaches, including clinical examination and advanced functional studies, for optimal patient management.
  • To guide clinicians in selecting appropriate therapies based on the predominant mechanism of constipation.

Main Methods:

  • Clinical anorectal examination, including digital rectal examination.
  • Functional diagnostic studies such as anal manometry, transrectal ultrasonography, and defecography.
  • Evaluation of patients with chronic constipation unresponsive to standard laxative treatments.

Main Results:

  • Digital rectal examination can identify dyschezia, but functional studies provide essential confirmation.
  • Diagnostic methods like anal manometry, ultrasonography, and defecography offer detailed insights into rectal outlet obstruction severity and rectal hyposensitivity.
  • These studies can reveal correctable anatomical anomalies contributing to constipation, such as rectocele, enterocele, or rectoanal intussusception.

Conclusions:

  • Clinical anorectal examination and functional studies are indispensable and complementary tools in evaluating chronic constipation.
  • Accurate diagnosis of the predominant constipation mechanism is vital for tailoring treatment plans.
  • A comprehensive diagnostic approach ensures optimal management for patients with refractory chronic constipation.