Topic
Defecography
About: Defecography is a research topic. Over the lifetime, 838 publications have been published within this topic receiving 21688 citations.
Papers published on a yearly basis
Papers
TL;DR: The proposed constipation scoring system correlated well with objective physiologic findings in constipated patients to allow uniformity in assessment of the severity of constipation.
Abstract: PURPOSE: Constipation is a common complaint; however, clinical presentation varies with each individual. The aim of this study was to assess a standard scoring system for evaluation of constipated patients. MATERIALS AND METHODS: All consecutive patients with idiopathic constipation who were referred for anorectal physiologic testing were assessed. A subjective constipation score was calculated based on a detailed questionnaire that included over 100 constipation-related symptoms. Based on the questionnaire, scores ranged from 0 to 30, with 0 indicating normal and 30 indicating severe constipation. The constipation score was then compared with the objective findings of the physiology tests, which include colonic transit time (CTT), anal manometry (AM), cinedefecography (CD), and electromyography (EMG). Colonic inertia was defined as diffuse marker delay on CTT without evidence of paradoxical contraction on AM, CD, or EMG. Pelvic outlet obstruction was defined as paradoxical puborectalis contraction, rectal prolapse or rectoanal intussusception, rectocele, or sigmoidocele. RESULTS: A total of 232 patients (185 females and 47 males) of a mean age of 64.9 (range, 14–92) years were evaluated. All patients had a score of more than 15; on evaluation of the significance of different symptoms in the constipation score with the Pearson's linear correlation test, 8 of 18 factors were identified as significant (P<0.05). These factors included frequency of bowel movements, painful evacuation, incomplete evacuation, abdominal pain, length of time per attempt, assistance for evacuation, unsuccessful attempts for evacuation per 24 hours, and duration of constipation. All 232 patients had objective obstruction attributable to one or more of the following causes: paradoxical puborectalis contraction (81), significant rectocele or sigmoidocele (48), rectoanal intussusception (64), and rectal prolapse (9). CONCLUSION: The proposed constipation scoring system correlated well with objective physiologic findings in constipated patients to allow uniformity in assessment of the severity of constipation.
1,186 citations
TL;DR: Biofeedback improves constipation and physiologic characteristics of bowel function in patients with dyssynergia, mediated by modifying physiologic behavior and colorectal function.
373 citations
TL;DR: Study of the mean values of the anorectal angle (ARA) reveals an increase in the ARA in IRI and ESRP and a decrease in AIPR, and the most striking observation is a highly significant increase inThe ARA associated with incontinence.
Abstract: Our simple method of defecography has proved to be more sensitive than clinical evaluation in the detection and description of defecation disorders. Among the different types of disorders, described on the basis of 144 abnormal defecograms, the most common are rectal intussusception (RI), intraanal rectal intussusception (IRI), external manually (EMRP) or spontaneously (ESRP) reducible prolapses, rectocele, and accentuation of the impression of the puborectalis sling (AIPR). Study of the mean values of the anorectal angle (ARA) (normal mean value=92° at rest) reveals an increase (p<0.05) in the ARA in IRI and ESRP and a decrease (p<0.05 at rest,p<0.001 at strain) in AIPR. The most striking observation is a highly significant increase (p<0.001) in the ARA associated with incontinence.
260 citations
TL;DR: Although useful, Rome II criteria may be insufficient to identify or subclassify dyssynergic defecation and symptoms together with abnormal manometry, abnormal balloon expulsion or colonic marker retention are necessary to optimally identify patients with difficultdefecation.
Abstract: Although 30-50% of constipated patients exhibit dyssynergia, an optimal method of diagnosis is unclear. Recently, consensus criteria have been proposed but their utility is unknown. To examine the diagnostic yield of colorectal tests, reproducibility of manometry and utility of Rome II criteria. A total of 100 patients with difficult defecation were prospectively evaluated with anorectal manometry, balloon expulsion, colonic transit and defecography. Fifty-three patients had repeat manometry. During attempted defecation, 30 showed normal and 70 one of three abnormal manometric patterns. Forty-six patients fulfilled Rome criteria and showed paradoxical anal contraction (type I) or impaired anal relaxation (type III) with adequate propulsion. However, 24 (34%) showed impaired propulsion (type II). Forty-five (64%) had slow transit, 42 (60%) impaired balloon expulsion and 26 (37%) abnormal defecography. Defecography provided no additional discriminant utility. Evidence of dyssynergia was reproducible in 51 of 53 patients. Symptoms alone could not differentiate dyssynergic subtypes or patients. Dyssynergic patients exhibited three patterns that were reproducible: paradoxical contraction, impaired propulsion and impaired relaxation. Although useful, Rome II criteria may be insufficient to identify or subclassify dyssynergic defecation. Symptoms together with abnormal manometry, abnormal balloon expulsion or colonic marker retention are necessary to optimally identify patients with difficult defecation.
247 citations
TL;DR: F Fluoroscopic x-ray defecography with an open-configuration magnet allows accurate assessment of anorectal morphology and function in relation to surrounding structures without exposing the patient to harmful ionizing radiation.
Abstract: Functional disorders of the pelvic floor are a common clinical problem. Diagnosis and treatment of these disorders, which frequently manifest with nonspecific symptoms such as constipation or incontinence, remain difficult. Fluoroscopic x-ray defecography has been shown to aid in detection of functional and morphologic abnormalities of the anorectal region. With the advent of open-configuration magnetic resonance (MR) imaging systems, MR defecography with the patient in a vertical position became possible. MR defecography permits analysis of the anorectal angle, the opening of the anal canal, the function of the puborectal muscle, and the descent of the pelvic floor during defecation. Good demonstration of the rectal wall permits visualization of intussusceptions and rectoceles. Excellent demonstration of the perirectal soft tissues allows assessment of spastic pelvic floor syndrome and descending perineum syndrome and visualization of enteroceles. MR defecography with an open-configuration magnet allows accurate assessment of anorectal morphology and function in relation to surrounding structures without exposing the patient to harmful ionizing radiation.
175 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2025 | 11 |
| 2024 | 12 |
| 2023 | 31 |
| 2022 | 67 |
| 2021 | 41 |
| 2020 | 28 |