By Eli D., M.D. Ehrenpreis
Even though rectal and perianal lawsuits are one of the commonest obvious via fundamental care physicians, surgeons, and gastroenterologists, the big variety of problems linked to those proceedings are, more often than not, poorly understood. also, numerous more moderen diagnostic resonance imaging, at the moment are being hired for the review of those issues. eventually, new pharmacotherapies, together with immunosuppressants and topical treatments in addition to new surgical remedies, have emerged. those are defined in a transparent, straightforward demeanour.
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Results obtained A number of studies have demonstrated that biofeedback therapy is highly successful for the treatment of pelvic floor-related defecation disorders (84% of patients undergoing the procedure report improvement in their symptoms). This technique is also relatively successful in patients with fecal incontinence. Complications There are no complications per se; the technique is usually well tolerated, although mild discomfort may occur. Additional comments Biofeedback therapy has also been utilized for the treatment of other forms of chronic constipation and for irritable bowel syndrome.
Patients are turned periodically to coat the entire colon with barium. Subsequently, air is instilled to provide air contrast by spreading the barium into a thin layer along the colonic wall. A balloon is placed and inflated in the rectum to prevent discharge of the barium. During the procedure, fluoroscopy and static x-rays are obtained at various angles to visualize all regions of the colon. After evacuation of the barium, the images of the colon are examined for mucosal abnormalities and anatomic disruptions.
Lateral rectoceles demonstrated on dynamic proctography. Figure 4. Oblique view of an anovaginal fistula seen on dynamic proctography. Figure 5. Pubococcygeal tear with herniation of rectal tissue (arrow) demonstrated on dynamic proctography. Hernia was only seen when the patient bore down with contrast in place during dynamic study. 33 Chapter 2 Complications Patient discomfort and barium impaction. Additional comments Dynamic proctography should be performed in a center where the staff have experience with the procedure.