| Theme | The Functional Gastrointestinal Disorders -- Clinical Practice Based on the Understanding of Its Basic Mechanisms | |
|---|---|---|
| Title | Examinations of Defecatory Disorders | |
| Publish Date | 2009/11 | |
| Author | Kotaro Maeda | Department of Surgery, Fujita Health University School of Medicine |
| Author | Tsunekazu Hanai | Department of Surgery, Fujita Health University School of Medicine |
| Author | Harunobu Sato | Department of Surgery, Fujita Health University School of Medicine |
| Author | Yoshikazu Koide | Department of Surgery, Fujita Health University School of Medicine |
| Author | Hiroshi Matsuoka | Department of Surgery, Fujita Health University School of Medicine |
| Author | Hidetoshi Katsuno | Department of Surgery, Fujita Health University School of Medicine |
| [ Summary ] | Defecation disorders include constipation, diarrhea and anal incontinence (gas and fecal incontinence). Constipation is classified into the categories of mechanical, functional and idiopathic conditions. The exclusion of mechanical bowel disorders must be initially considered when diagnosing constipation. Secondary constipation due to hypothyroidism and pelvic organ prolapse may be evaluated through physical examination and inspection, followed by functional examination. Anal incontinence primarialy occurs due to damage to the anorectal muscles and associated nerves. The grade of anal incontinence should be initially evaluated be by confirming the frequency of incontinence related gas, fluid stools or hard stools, as well as the need to wear a pad or the restriction of social activity. Functional examination, including anorectal manometry should be done at a later time. Pelvic organ prolapse and anal diseases such as hemorrhoids can induce anal incontinence, therefore anatomical examination through defecography is also mandatory to evaluate anal incontinence. The most important factor to diagnose defecation disorders is to fully evaluate all these findings. | |