Disorders of the Pelvic Floor and Anorectum, An Issue of Gastroenterology Clinics (The Clinics: Internal Medicine)

Cover......Page 1
Preface......Page 2
Pelvic Floor Anatomy and Applied Physiology......Page 4
External Anal Sphincter......Page 6
Puborectalis and deep pelvic floor muscles......Page 8
Pelvic floor imaging......Page 9
Sensory function of the rectum and anal canal......Page 11
Applied physiology......Page 12
Vaginal high-pressure zone......Page 13
Pelvic Floor Muscles and Fecal Incontinence......Page 15
Pelvic Floor Muscles and Constipation......Page 16
Summary......Page 17
References......Page 18
Manometric, Sensorimotor, and Neurophysiologic Evaluation of Anorectal Function......Page 21
Limitations......Page 23
Functional anal canal length......Page 24
Anal squeeze pressures......Page 25
Technique......Page 26
Technique......Page 27
Measurements and clinical use......Page 28
Ambulatory Anorectal Manometry......Page 29
Measurements and clinical use......Page 30
Barostat assembly......Page 31
Barostat distention......Page 32
Direct stimulation of the rectal mucosa (nonmechanical distention): thermal and electrostimulation......Page 33
Technique......Page 34
Rectal Tone......Page 35
Limitations and Implications for the Assessment of Rectal Compliance and Tone in Clinical Practice......Page 36
Measurements and clinical use......Page 37
Electromyography......Page 38
Measurements and clinical use......Page 39
Somatosensory (Cortical) Evoked Potentials......Page 40
References......Page 41
Urodynamic Evaluation of the Bladder and Pelvic Floor......Page 49
Cystometry......Page 50
Uroflowmetry......Page 54
Electromyography......Page 55
Indications......Page 57
Stress Urinary Incontinence and Pelvic Organ Prolapse......Page 58
References......Page 60
Defecography......Page 63
Pathology and Clinical Use......Page 64
Anal Endosonography......Page 65
Normal Findings......Page 66
Pathology and Clinical Use......Page 67
Pathology and Clinical Use......Page 69
Static MRI......Page 70
Interventional CT......Page 72
Summary......Page 73
References......Page 74
Epidemiology......Page 78
Duration and frequency of training......Page 79
Devices and techniques for biofeedback......Page 80
Efficacy of biofeedback therapy......Page 81
Anorectal Manometry......Page 82
Balloon Expulsion Test......Page 83
Treatment......Page 84
Fiber supplements......Page 85
Miscellaneous and emerging therapies......Page 86
Improve or correct dyssynergia......Page 87
Sensory training......Page 89
Summary......Page 91
References......Page 92
Fecal Incontinence and Biofeedback Therapy......Page 96
Patient assessment......Page 97
Elements of conservative care......Page 98
Bowel Habit......Page 99
Urge Resistance Training......Page 100
Different methods of biofeedback......Page 101
Co-ordination Training......Page 102
Electrical Stimulation......Page 103
Summary......Page 104
References......Page 109
Surgical Treatment of Patients with Constipation and Fecal Incontinence......Page 114
Effect of coexistent outlet obstruction......Page 115
Indications and patient selection......Page 116
Results and complications......Page 117
Current position controversies......Page 118
Indications and patient selection......Page 119
Indications and patient selection......Page 120
Results and complications......Page 121
Results and complications......Page 122
Sacral nerve stimulation......Page 123
Artificial bowel sphincter......Page 125
Perianal injection of biomaterials......Page 126
Rectal augmentation for storage dysfunction......Page 127
Summary......Page 128
References......Page 129
Etiology......Page 135
Diagnosis......Page 136
Sclerotherapy......Page 137
Infrared coagulation......Page 138
Hemorrhoidectomy......Page 139
Summary......Page 140
Fissure in ano......Page 141
Internal Anal Sphincter Physiology......Page 142
Calcium channel blockers......Page 143
Manual dilatation of the anus......Page 144
Lateral internal sphincterotomy......Page 145
References......Page 146
Definition, Etiology, and Pathogenesis......Page 153
Anorectal Function Tests......Page 154
Modified ripstein procedure by laparoscopic approach......Page 156
Results......Page 158
Symptomatology......Page 161
Treatment......Page 162
Diagnosis......Page 163
Physiotherapy and biofeedback training......Page 165
Definition, Etiology, and Pathogenesis......Page 166
Radiologic Investigation......Page 167
Posterior colporrhaphy......Page 168
Definition, Cause, Pathogenesis......Page 169
Treatment......Page 170
References......Page 171
Ileal Pouch Dysfunction: Diagnosis and Management......Page 177
Management......Page 178
Management......Page 179
Differential diagnosis......Page 181
Stricture of the ileoanal anastomosis......Page 182
Retained rectum after ileorectal anastomosis......Page 183
Sphincter Dysfunction......Page 184
Management......Page 185
Treatment......Page 186
Investigating Pouch Dysfunction......Page 187
References......Page 188
Functional and Chronic Anorectal and Pelvic Pain Disorders......Page 192
Epidemiology......Page 193
Treatment......Page 194
Management......Page 195
Clinical Features......Page 196
Management......Page 197
Pathophysiology......Page 198
References......Page 199
Pathophysiology of urinary incontinence......Page 204
Urinary incontinence among nursing home residents......Page 205
Treatment options for urinary incontinence among nursing home residents......Page 206
Fecal incontinence among nursing home residents......Page 208
Skin care in nursing home residents with incontinence......Page 210
References......Page 211
Constipation......Page 215
Physiology of defecation......Page 217
Functional constipation......Page 218
Diagnosis......Page 219
Management of children with functional constipation......Page 220
Nonretentive fecal incontinence......Page 223
Pathophysiology......Page 224
Diagnosis......Page 227
Anorectal malformations......Page 230
References......Page 231
Diagnosis and Management of Urinary Incontinence and Functional Fecal Incontinence (Encopresis) in Children......Page 237
Normal development of bladder and sphincter control......Page 238
Pathophysiology and classification of urinary incontinence......Page 239
Epidemiology of urinary incontinence......Page 241
Urinary Incontinence and Behavioral Problems......Page 242
Uroflowmetry......Page 243
Assessment of Fecal Retention......Page 244
Nonpharmacological treatments of urinary incontinence......Page 245
Pharmacologic therapy of urinary incontinence......Page 247
Functional nonretentive soiling......Page 248
References......Page 249