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Anorectal Manometry
Anorectal manometry (ARM) is a medical test used to measure pressures in the anus and rectum and to assess their function. The test is performed by inserting a catheter, that contains a probe embedded with pressure sensors, through the anus and into the rectum. Patients may be asked to perform certain maneuvers, such as coughing or attempting to defecate, to assess for pressure changes. Anorectal manometry is a safe and low risk procedure. From 2014 to 2018, the international anorectal physiology working group (IAPWG) meet several times to develop consensus on indications for anorectal manometry. Their assessment concluded that anorectal manometry was indicated when used in assessment of fecal incontinence, constipation, evacuation disorders (including Hirschsprung's disease), functional anorectal pain and in the assessment of anorectal function preoperatively or after a traumatic obstetric injury. In addition to the indications outlined by the IAPWG, anorectal manometry has be ...
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Medical Test
A medical test is a medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, or to determine a course of treatment. Medical tests such as, physical and visual exams, diagnostic imaging, genetic testing, chemical and cellular analysis, relating to clinical chemistry and molecular diagnostics, are typically performed in a medical setting. Types of tests By purpose Medical tests can be classified by their purposes, the most common of which are diagnosis, screening and evaluation. Diagnostic A diagnostic test is a procedure performed to confirm or determine the presence of disease in an individual suspected of having a disease, usually following the report of symptoms, or based on other medical test results. This includes posthumous diagnosis. Examples of such tests are: * Using nuclear medicine to examine a patient suspected of having a lymphoma. * Measuring the blood sugar in a person suspected of having diabetes mellitus after ...
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Internal Anal Sphincter
The internal anal sphincter, IAS, (or sphincter ani internus) is a ring of smooth muscle that surrounds about 2.5–4.0 cm of the anal canal; its inferior border is in contact with, but quite separate from, the external anal sphincter. It is myogenic in nature and playing phasic and tonic state for relaxation and contraction. This myogenic tone is based on Ca2+/Calmodulin/MLCK/RhoA/ROCK signaling cascade pathway. Recent studies suggested, BDNF is the member of the neurotrophin family; having next target for basal IAS and NANC relaxation. It is about 5 mm thick, and is formed by an aggregation of the involuntary circular fibers of the rectum. Its lower border is about 6 mm from the orifice of the anus. Actions Its action is entirely involuntary, and it is in a state of continuous maximal contraction. It helps the Sphincter ani externus to occlude the anal aperture and aids in the expulsion of the feces. Sympathetic fibers from the superior rectal and hypogastric p ...
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Intussusception (medical Disorder)
Intussusception is a medical condition in which a part of the intestine folds into the section immediately ahead of it. It typically involves the small bowel and less commonly the large bowel. Symptoms include abdominal pain which may come and go, vomiting, abdominal bloating, and bloody stool. It often results in a small bowel obstruction. Other complications may include peritonitis or bowel perforation. The cause in children is typically unknown; in adults a ''lead point'' is sometimes present. Risk factors in children include certain infections, diseases like cystic fibrosis, and intestinal polyps. Risk factors in adults include endometriosis, bowel adhesions, and intestinal tumors. Diagnosis is often supported by medical imaging. In children, ultrasound is preferred while in adults a CT scan is preferred. Intussusception is an emergency requiring rapid treatment. Treatment in children is typically by an enema with surgery used if this is not successful. Dexamethasone ma ...
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Enterocele
An enterocele is a protrusion of the small intestines and peritoneum into the vaginal canal. It may be treated transvaginally or by laparoscopy. An enterocele may also obstruct the rectum, leading to symptoms of obstructed defecation. Enteroceles can form after treatment for gynecological cancers. See also *Dolichodouglas A Dolichodouglas (word derived from ancient Greek Δόλιχος (dolichos), the long distance in running and the Douglas' pouch) is the medical term describing an abnormally profound Douglas' pouch (recto-uterine pouch). It may be congenital or ac ... References External links {{Womens-health-stub Noninflammatory disorders of female genital tract Women's health ...
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Rectocele
In gynecology, a rectocele ( ) or posterior vaginal wall prolapse results when the rectum bulges ( herniates) into the vagina. Two common causes of this defect are childbirth and hysterectomy. Rectocele also tends to occur with other forms of pelvic organ prolapse, such as enterocele, sigmoidocele and cystocele. Although the term applies most often to this condition in females, males can also develop it. Rectoceles in men are uncommon, and associated with prostatectomy. Signs and symptoms Mild cases may simply produce a sense of pressure or protrusion within the vagina, and the occasional feeling that the rectum has not been completely emptied after a bowel movement. Moderate cases may involve difficulty passing stool (because the attempt to evacuate pushes the stool into the rectocele instead of out through the anus), discomfort or pain during evacuation or intercourse, constipation, and a general sensation that something is "falling down" or "falling out" within the pelvis. Se ...
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Pelvic Floor
The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below. Both males and females have a pelvic floor. To accommodate the birth canal, a female's pelvic cavity is larger than a male's. Structure The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during ...
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Force
In physics, a force is an influence that can change the motion of an object. A force can cause an object with mass to change its velocity (e.g. moving from a state of rest), i.e., to accelerate. Force can also be described intuitively as a push or a pull. A force has both magnitude and direction, making it a vector quantity. It is measured in the SI unit of newton (N). Force is represented by the symbol (formerly ). The original form of Newton's second law states that the net force acting upon an object is equal to the rate at which its momentum changes with time. If the mass of the object is constant, this law implies that the acceleration of an object is directly proportional to the net force acting on the object, is in the direction of the net force, and is inversely proportional to the mass of the object. Concepts related to force include: thrust, which increases the velocity of an object; drag, which decreases the velocity of an object; and torque, which produce ...
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Defecation
Defecation (or defaecation) follows digestion, and is a necessary process by which organisms eliminate a solid, semisolid, or liquid waste material known as feces from the digestive tract via the anus. The act has a variety of names ranging from the common, like pooping or crapping, to the technical, e.g. bowel movement, to the obscene ('' shitting''), to the euphemistic ("dropping a deuce" or "taking a dump"). The topic, usually avoided among polite company, can become the basis for some potty humour. Humans expel feces with a frequency varying from a few times daily to a few times weekly. Waves of muscular contraction (known as ''peristalsis'') in the walls of the colon move fecal matter through the digestive tract towards the rectum. Undigested food may also be expelled this way, in a process called ''egestion''. When birds defecate, they also expel urine and urates in the same mass, whereas other animals may also urinate at the same time, but spatially separated. Defeca ...
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Paradox
A paradox is a logically self-contradictory statement or a statement that runs contrary to one's expectation. It is a statement that, despite apparently valid reasoning from true premises, leads to a seemingly self-contradictory or a logically unacceptable conclusion. A paradox usually involves contradictory-yet-interrelated elements that exist simultaneously and persist over time. They result in "persistent contradiction between interdependent elements" leading to a lasting "unity of opposites". In logic, many paradoxes exist that are known to be invalid arguments, yet are nevertheless valuable in promoting critical thinking, while other paradoxes have revealed errors in definitions that were assumed to be rigorous, and have caused axioms of mathematics and logic to be re-examined. One example is Russell's paradox, which questions whether a "list of all lists that do not contain themselves" would include itself, and showed that attempts to found set theory on the identification ...
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Anismus
Anismus or dyssynergic defecation is the failure of normal relaxation of pelvic floor muscles during attempted defecation. It can occur in both children and adults, and in both men and women (although it is more common in women). It can be caused by physical defects or it can occur for other reasons or unknown reasons. Anismus that has a behavioral cause could be viewed as having similarities with parcopresis, or psychogenic fecal retention. Symptoms include tenesmus (the sensation of incomplete emptying of the rectum after defecation has occurred) and constipation. Retention of stool may result in fecal loading (retention of a mass of stool of any consistency) or fecal impaction (retention of a mass of hard stool). This mass may stretch the walls of the rectum and colon, causing megarectum and/or megacolon, respectively. Liquid stool may leak around a fecal impaction, possibly causing degrees of liquid fecal incontinence. This is usually termed encopresis or soiling in children, ...
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Rectal Examination
Digital rectal examination (DRE; la, palpatio per anum, PPA) is an internal examination of the rectum, performed by a healthcare provider. Prior to a 2018 report from the U.S. Preventive Services Task Force, the DRE was a common and "dreaded" component of annual exams for older men, as it was thought to be a reliable screening test for prostate cancer. Usage This examination may be used * for the diagnosis of prostatic disorders, benign prostatic hyperplasia and the four types of prostatitis. Chronic prostatitis/chronic pelvic pain syndrome, chronic bacterial prostatitis, acute (sudden) bacterial prostatitis, and asymptomatic inflammatory prostatitis. The DRE has a 50% specificity for benign prostatic hyperplasia. Vigorous examination of the prostate in suspected acute prostatitis can lead to seeding of septic emboli and should never be done. Its utility as a screening method for prostate cancer however is not supported by the evidence; * for the evaluation of certain clinical ...
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Dietary Fiber
Dietary fiber (in British English fibre) or roughage is the portion of plant-derived food that cannot be completely broken down by human digestive enzymes. Dietary fibers are diverse in chemical composition, and can be grouped generally by their solubility, viscosity, and fermentability, which affect how fibers are processed in the body. Dietary fiber has two main components: soluble fiber and insoluble fiber, which are components of plant-based foods, such as legumes, whole grains and cereals, vegetables, fruits, and nuts or seeds. A diet high in regular fiber consumption is generally associated with supporting health and lowering the risk of several diseases. Dietary fiber consists of non- starch polysaccharides and other plant components such as cellulose, resistant starch, resistant dextrins, inulin, lignins, chitins (in fungi), pectins, beta-glucans, and oligosaccharides. Food sources of dietary fiber have traditionally been divided according to whether they provide s ...
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