Defecography in normal volunteers: results and implications.

Shorvon, P; McHugh, Sean M.; Diamant, Nicholas E.; Somers, Sat; Stevenson, Giles W.

doi:10.1136/gut.30.12.1737

Cited by 703 publications

(441 citation statements)

References 17 publications

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“…Intussusception has been demonstrated in healthy volunteers and some degree of this disorder might be a normal finding. 23 We found that descending perineum syndrome was more frequently observed in males, contrary to previous studies. 24,25 Although we lack an explanation, we hypothesize that it could be due to the fewer numbers of men in our study.…”

Section: Discussioncontrasting

confidence: 56%

“…This is in agreement with previous studies. 23,26 The following risk factors were most commonly seen in women: Abnormal descend of the fetal head, the performance of instrumental deliveries, obesity, and chronic obstructive pulmonary disease. 27 Arnold et al published a case-series in which constipation did not disappear in most patients after rectocele repair.…”

Section: Discussionmentioning

confidence: 99%

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Defecographic Findings in Patients with Severe Idiopathic Chronic Constipation

Rafiei

Bayat

Taheri

et al. 2017

Korean J Gastroenterol

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Background/Aims: Chronic constipation is a common gastrointestinal disorder diagnosed using Rome III criteria. Defecography is a radiographic method used to identify anatomic abnormalities of anorectum. The present study aimed to evaluate the defecographic findings in patients with severe idiopathic chronic constipation. Methods: One hundred patients, who complained of severe idiopathic chronic constipation with abnormal balloon expulsion test, underwent defecography after injection of barium. An analysis of radiographs was performed by an expert radiologist for the diagnosis of descending perineum syndrome, rectocele, enterocele, rectal ulcer, rectal prolapse, fecal residue of post defecation, and etc. Then, they were compared between the two sexes. Results: Normal defecography was only observed in two participants. Descending perineum syndrome was the most common abnormality (73.3%). The results showed that rectocele (80.8%) and descending perineum syndrome (69.2%) were most frequent in women. In males, descending perineum syndrome and rectal prolapse were more prevalent (87% and 43.5%, respectively). Compared with men, rectocele and rectal ulcer were more frequently observed in women (p<0.001, and p=0.04, respectively), while men were more affected by descending perineum syndrome (p=0.04). In total, women had a greater incidence of abnormal defecographic findings compared with men (p=0.02). Conclusions: Defecography can be performed to detect anatomic abnormalities in patients with severe idiopathic chronic constipation and abnormal balloon expulsion test. This technique can assist physicians in making the most suitable decision for surgical procedure. (Korean J Gastroenterol 2017;70:39-43)

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Defecographic Findings in Patients with Severe Idiopathic Chronic Constipation

Rafiei

Bayat

Taheri

et al. 2017

Korean J Gastroenterol

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“…Others have failed to demonstrate any correlation between defecography findings and surgical outcome (14,16) . Nevertheless, rectocele is rather frequently observed in asymptomatic nulliparous volunteers (34) . In this study the constipation score improved without surgical repair in approximately half the patients (clinical management alone = 33%; clinical management + biofeedback = 13.6%).…”

Section: Discussionmentioning

confidence: 99%

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Murad-Regadas

Regadas

Rodrigues

et al. 2012

Arq. Gastroenterol.

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-Context -Management of patients with obstructed defecation syndrome is still controversial. Objective -To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. Methods -The study included 103 females aged 26-84 years with obstructed defecation, grade-II/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33%) patients with significant improvement of symptoms through clinical management only. Group II: 14 (14%) with improvement through clinical treatment plus biofeedback. Group III: 55 (53%) referred to surgery due to treatment failure. Results -Group I: 20 (59%) patients had grade-II rectocele, 14 (41%) grade-III. Obstructed defecation syndrome was associated with intussusception (41%), mucosal prolapse (41%), anismus (29%), enterocele (9%) or 2 dysfunctions (23%). The average constipation score decreased significantly from 11 to 5. Group II: 11 (79%) grade-II rectocele, 3 (21%) grade-III, associa ted with intussusception (7%), mucosal prolapse (43%), anismus (71%) or 2 dysfunctions (29%). There was significant decrease in constipation score from 13 to 6. Group III: 8 (15%) grade-II rectocele, 47 (85%) grade-III, associated with intussusception (42%), mucosal prolapse (40%) or 2 dysfunctions (32%). The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31%) patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. Conclusions -Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and/or biofeedback. Surgical repair was mainly required in patients with grade-III rectocele whose constipation scores remained high despite all efforts. HEADINGS -Rectocele. Constipation. Pelvic floor. Imaging, three-dimensional.None disclosure.

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“…(27) Goei et al, 1989 (28) Shorvon et al, 1989 (29) Freimanis et al, 1991 (19) Mezwa et al, 1993 (18) Somers, 1994 (9) Ikenberry et al, 1996 …”

Section: Conclusãomentioning

confidence: 99%

Avaliação do ângulo ano-retal por meio de defecograma em voluntárias assintomáticas nulíparas e multíparas

et al. 2003

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Santos JEM et al. Radiol Bras 2003;36(4):219224 219 INTRODUÇÃOEste trabalho objetivou preencher uma lacuna na literatura nacional a respeito do exame de defecograma e comparar os achados radiográficos obtidos entre nulíparas e multíparas assintomáticas, assunto pouco explorado na literatura mundial.As primeiras tentativas de estudo dos mecanismos da defecação tiveram início na década de 60(1-3 OBJETIVO: Fizemos um protocolo para compararmos as medidas dos ângulos ano-retais em três situações diferentes, em voluntárias assintomáticas nulíparas e multíparas. CASUÍSTICA E MÉTODOS: Foram realizados defecogramas em 30 mulheres (15 nulíparas e 15 multíparas), de maio de 1997 a dezembro de 1998, e obtidas incidências radiográficas em perfil do reto após introdução de contraste baritado texturizado: em repouso, durante contração do músculo puborretal e durante a evacuação. Na análise estatística foi utilizada a análise de medidas repetidas. RESULTADOS: A média do ângulo não apresentou diferença significante entre as voluntárias nulíparas e multíparas. O ângulo mediu, nas nulíparas, 92,9° em repouso, 78,8°d urante a contração do músculo puborretal e 117,9° durante a evacuação, e nas multíparas mediu 94,3°e m repouso, 79,7° durante a contração do músculo puborretal e 121,4° durante a evacuação. Foi observada diferença significante entre os ângulos em repouso, durante a contração do músculo puborretal e durante a evacuação. CONCLUSÃO: Não houve diferença significante entre os dois grupos examinados. Unitermos: Defecografia; Ânus; Reto; Defecação; Pelve; Feminino.Measurement of the anorectal angle by defecography in asymptomatic nulliparous and multiparous volunteers. OBJECTIVE: We developed a protocol to compare the measurements of the anorectal angle in nulliparous and multiparous asymptomatic volunteers in three different situations. SUBJECTS AND METHODS: Defecograms were carried out in 30 women (15 nulliparous and 15 multiparous) from May, 1997 to December, 1998. After rectal administration of texturized barium contrast media, lateral radiographic views of the rectum were obtained at rest, during contraction of the puborectal muscle and during defecation. A repeated measures model was used for the statistical analysis. RESULTS: There were no significant differences between the mean anorectal angles of nulliparous and multiparous volunteers. Measurements were as follows: 92.9° at rest, 78.8° during the contraction of the puborectal muscle and 117.9° during defecation for the nulliparous volunteers; 94.3° at rest, 79.7° during the contraction of the puborectal muscle and 121.4° during defecation for the multiparous volunteers. A significant difference was observed between the anorectal angle measurements at rest, during contraction of the puborectal muscle and during defecation. CONCLUSION: There were no significant differences between the anorectal angle measurements of the two groups of volunteers examined. A média do ângulo ano-retal (AAR) normal observada pelos autores foi de 92° (± 1,52 EMP) em repouso e de 137° (± 1...

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Defecography in normal volunteers: results and implications.

Cited by 703 publications

References 17 publications

Defecographic Findings in Patients with Severe Idiopathic Chronic Constipation

Defecographic Findings in Patients with Severe Idiopathic Chronic Constipation

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Avaliação do ângulo ano-retal por meio de defecograma em voluntárias assintomáticas nulíparas e multíparas

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