1 / 14

Examining for rectal prolapse

Examining for rectal prolapse. Most NOT evident in lying position as rest Ask patient to bear down – most still not evident

conlan
Télécharger la présentation

Examining for rectal prolapse

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Examining for rectal prolapse • Most NOT evident in lying position as rest • Ask patient to bear down – most still not evident • Need to examine after straining on the toilet for 1-2 minutes – lean forward – observe from behind – estimate in centimetres - ? full thickness circumferential, or partial mucosal only?

  2. Ano-rectal digital examination • Resting tone (low = IAS problem) • Squeeze pressure (low = EAS problem) • Co-ordination • Pubo-rectalis (pelvic floor function) • Sensation (? Neurological dysfunction) • Assessment stops here for MOST patients

  3. Abdominal transit study • Patient takes 20 radio-opaque markers on 3 consecutive days • Attends for plain abdominal X-ray on day 6 • 80% of markers should have been passed • Can distinguish slow whole gut transit from rectal outlet delay

  4. Assessment • Most can be done by a nurse • Takes time (we allow 1 hour in my clinic) • Remember how embarrassed most patients will be • Many patients have more than one cause (especially older people) • If you find the cause, you often know how to treat

  5. Website: www.bowelcontrol.org.uk

More Related