Update on the pathophysiology and management of anorectal disorders

Tanisa Patcharatrakul, Satish S.C. Rao

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Anorectal disorders are common and present with overlapping symptoms. They include several disorders with both structural and functional dysfunction(s). Because symptoms alone are poor predictors of the underlying pathophysiology, a diagnosis should only be made after evaluating symptoms and physiologic and structural abnormalities. A detailed history, a thorough physical and digital rectal examination and a systematic evaluation with high resolution and/or high definition three-dimensional (3D) anorectal manometry, 3D anal ultrasonography, magnetic resonance defecography and neurophysiology tests are essential to correctly identify these conditions. These physiological and imaging tests play a key role in facilitating a precise diagnosis and in providing a better understanding of the pathophysiology and functional anatomy. In turn, this leads to better and more comprehensive management using medical, behavioral and surgical approaches. For example, patients presenting with difficult defecation May demonstrate dyssynergic defecation and will benefit from biofeedback therapy before considering surgical treatment of coexisting anomalies such as rectoceles or intussusception. Similarly, patients with significant rectal prolapse and pelvic floor dysfunction or patients with complex enteroceles and pelvic organ prolapse May benefit from combined behavioral and surgical approaches, including an open, laparoscopic, transabdominal or transanal, and/or robotic-assisted surgery. Here, we provide an update on the pathophysiology, diagnosis, and management of selected common anorectal disorders.

Original languageEnglish (US)
Pages (from-to)375-384
Number of pages10
JournalGut and Liver
Volume12
Issue number4
DOIs
StatePublished - Jul 2018

Fingerprint

Rectal Diseases
Defecation
Defecography
Rectal Prolapse
Pelvic Organ Prolapse
Digital Rectal Examination
Neurophysiology
Pelvic Floor
Intussusception
Manometry
Robotics
Hernia
Ultrasonography
Anatomy
Magnetic Resonance Spectroscopy
History
Therapeutics

Keywords

  • Constipation
  • Defecation
  • Pelvic floor
  • Rectal diseases

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Update on the pathophysiology and management of anorectal disorders. / Patcharatrakul, Tanisa; Rao, Satish S.C.

In: Gut and Liver, Vol. 12, No. 4, 07.2018, p. 375-384.

Research output: Contribution to journalReview article

Patcharatrakul, Tanisa ; Rao, Satish S.C. / Update on the pathophysiology and management of anorectal disorders. In: Gut and Liver. 2018 ; Vol. 12, No. 4. pp. 375-384.
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