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Drugs for Treatment of Diarrhea-Predominant IBS

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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
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Related Experiment Video

Updated: Jun 19, 2026

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse (POP) Quantification System
03:49

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse (POP) Quantification System

Published on: September 20, 2018

The Association Between Levator Ani Integrity and Postpartum Ano-Rectal Dysfunction: A Systematic Review.

Adéla Samešová1,2,3, Rafaël Kiebooms1, Laura Cattani1,4

  • 1Department Development and Regeneration, Cluster Urogenital, Abdominal and Plastic Surgery, KU Leuven, Leuven, Belgium.

International Urogynecology Journal
|January 17, 2025
PubMed
Summary

This study found no link between levator ani muscle (LAM) avulsion and postpartum ano-rectal dysfunction. Childbirth does not appear to cause incontinence symptoms due to LAM avulsion.

Keywords:
Anal dysfunctionChildbirthLevator ani musclePelvic floor ultrasoundPostpartumPuborectalis muscle

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Area of Science:

  • Obstetrics and Gynecology
  • Pelvic Floor Disorders
  • Female Pelvic Medicine

Background:

  • Pregnancy and childbirth can lead to ano-rectal dysfunction.
  • Vaginal delivery may affect pelvic floor structure and function.
  • Levator ani muscle (LAM) avulsion is a potential consequence of childbirth.

Purpose of the Study:

  • To systematically review the literature on the association between levator ani muscle (LAM) avulsion and ano-rectal function after childbirth.
  • To investigate the impact of LAM avulsion on pelvic floor functionality post-delivery.

Main Methods:

  • Systematic literature search across multiple databases (PubMed, EMBASE, etc.).
  • Inclusion of studies assessing LAM anatomy (imaging) and ano-rectal function (questionnaires, manometry) within 24 months postpartum.
  • Meta-analysis and subgroup analysis (with/without anal sphincter trauma) to pool data on LAM avulsion and ano-rectal function.

Main Results:

  • 11 studies involving 2,146 women were included.
  • Levator ani muscle (LAM) avulsion showed no statistically significant association with incontinence symptoms (OR 1.75 [0.74, 4.12]).
  • This lack of association persisted in the subgroup with concomitant anal sphincter injury (OR 1.83 [0.71, 4.71]).

Conclusions:

  • No evidence of an association between levator ani muscle (LAM) avulsion and ano-rectal dysfunction was identified following vaginal childbirth.
  • Postpartum ano-rectal dysfunction is not directly linked to LAM avulsion based on current literature.