Obstetric anal sphincter injuries (OASIS) is the most common cause of fecal incontinence (FI) in women. Obstetric-related FI may occur early after childbirth. Previous obstetric injury is also a major cause of FI in older women, and risk of FI increases with time and further childbirths. FI is involuntary loss of solid or liquid stool. Symptoms range from fecal urgency, soiling, to daily passive or urge fecal incontinence. FI is a stigmatizing condition. It can have a distressing impact and restriction on quality of life, including isolation and depression.. Tears during delivery is classified (Sultan) as first degree tears including vaginal epithelium, second degree tears into the perineal muscle, third degree involving the anal sphincter complex and fourth degree including sphincter complex and anorectal epithelium. OASIS includes third and fourth degrees tears.. First line of therapy of FI is conservative treatment including drug therapy and biofeedback. If conservative treatment fails, ...
The anal and rectal area contains specialized muscles that are helpful to regulate proper passage of bowel movements.. Normally, when stool enters the rectum, the anal sphincter muscle tightens to prevent passage of stool at an inconvenient time. If this muscle is weak or does not contract in a timely way, incontinence (leakage of stool) may occur.. Normally, when a person pushes or bears down to have a bowel movement, the anal sphincter muscles relax. This will cause the pressures to decrease allowing evacuation of stool. If the sphincter muscles tighten when pushing, this could contribute to constipation. Anal manometry measures how strong the sphincter muscles are and whether they relax as they should during passing a stool. It provides helpful information to the doctor in treating patients with fecal incontinence or severe constipation.. There are many causes of fecal incontinence. Weak anal sphincter muscles or poor sensation in the rectum can contribute to fecal incontinence. If these ...
PURPOSE:. Paradoxical puborectalis contraction during defecation is one possible explanation for constipation. The degree of paradoxical contraction can be evaluated by intramuscular electromyography from the puborectalis and external anal sphincter muscles. This study aimed to determine whether a noninvasive technique with surface electrodes placed over the subcutaneous part of the external anal sphincter is feasible in the evaluation of paradoxical activity.. METHODS:. Twenty-five patients with constipation were studied. Sphincter muscle activity during strain and squeeze maneuvers was recorded using surface electrodes placed 1 cm from the anal verge. In addition, intramuscular recordings were made simultaneously from the external anal sphincter and puborectalis muscles. The degree of paradoxical activation was calculated as a strain/squeeze index. The patients were examined either in the left lateral position or sitting on a commode.. RESULTS:. The study revealed significant (P , .01) ...
The internal anal sphincter, IAS, (or sphincter ani internus) is a muscular ring that surrounds about 2.5-4.0 cm of the anal canal; its inferior border is in contact with, but quite separate from, the external anal sphincter. It is about 5 mm thick, and is formed by an aggregation of the involuntary circular fibers of the rectum. Its lower border is about 6 mm from the orifice of the anus. Its action is entirely involuntary, and it is in a state of continuous maximal contraction. It helps the Sphincter ani externus to occlude the anal aperture and aids in the expulsion of the feces. Sympathetic fibers from the superior rectal and hypogastric plexuses stimulate and maintain internal anal sphincter contraction. Its contraction is inhibited by parasympathetic fiber stimulation. This sphincter is tonically contracted most of the time to prevent leakage of fluid or gas, but is relaxed upon distention of the rectal ampulla, requiring voluntary contraction of the puborectalis and external anal ...
Cesarean Sections and Anal Sphincter InjuriesOccurrence of obstetric anal sphincter injuries found by 3D EAUS among primiparas delivered by cesarean section: a pilot study ...
OBJECTIVES: The aim of this study was to determine sphincter volume, length, and external anal sphincter thickness in healthy controls and fecal incontinent patients by use of a three-dimensional reconstruction of endoanal ultrasonography images. MET
Anismus or "spastic pelvic floor syndrome" is thought to be one cause of severe constipation.2 7 Its pathophysiological basis is PSC during straining. However, there is no single test by which the diagnosis can be confirmed so it is possible that it is a laboratory artefact. None the less, operations to solve the problem by posterior division of the puborectalis muscle have been performed.8 During the past few years functional outlet obstruction has been widely acknowledged as a cause of chronic constipation. In organic diseases such as tumour stenosis, outlet obstruction is continuously maintained by a rectal tumour mass. On the other hand, in functional forms of outlet obstruction the physiology is normal when the patient does not defaecate and becomes pathological only during defaecation. Paradoxical sphincter contraction during straining has been claimed as one of the main causes of functional outlet obstruction.9 The concept of PSC as a specific finding in constipated patients has been ...
Nitroglycerine (glyceryl trinitrate) is used for treatment of anal fissure, as it has muscle relaxant property. Spasm of internal anal sphincter muscles, which reduce blood flow to the internal anal sphincter muscles possibly play an important role in causation of anal fissure as well in healing of anal fissures and ...
Bloating Worsens Constipation. One condition that can trigger your internal anal sphincter muscle to tighten up is a big accumulation of gas (flatulence) in your colon. If you have so much gas that your abdominal area is puffed up, then the pressure from that quantity of gas in the colon triggers the internal anal sphincter muscle to tighten up and close.. In this case, you have to very first eliminate the pressure by getting a few of the gas out, prior to you attempt to have a defecation. The very best method to do this is by lying flat on your bed, doing some colonic massage, then lying flat once again and simply permitting your body to entirely unwind and release. Sleep, or check out a book, however rest totally flat in whatever position is comfy for you (in your corner, your stomach, etc) and enable the gas to come out, as your body is all set to launch it.. ColoZone Plus works to help with bowel regularity and constipation, colon cleanse, reduce stomach acid and also acts as a magnesium ...
TY - JOUR. T1 - Robotic versus laparoscopic coloanal anastomosis with or without intersphincteric resection for rectal cancer. AU - Baek, Se-Jin. AU - AL-Asari, Sami. AU - Jeong, Duck Hyoun. AU - Hur, Hyuk. AU - Min, Byung Soh. AU - Baik, Seung Hyuk. AU - Kim, Nam Kyu. PY - 2013/1/1. Y1 - 2013/1/1. N2 - Robotic surgery is increasingly used in the field of rectal cancer surgery. This study aimed to compare the short- and long-term outcomes between robotic and laparoscopic ultralow anterior resection (uLAR) and coloanal anastomosis (CAA). Between January 2007 and December 2010, a retrospective chart review was performed for all patients with low rectal cancer who underwent curative uLAR and CAA with or without intersphincteric resection using either a robotic or a laparoscopic approach. The study excluded patients with tumors invading the levator ani or external sphincter, patients with T4 cancers invading the prostate or vagina, and patients for whom an open approach was used. Patients short- ...
The primary functions of the rectum and pelvic floor muscles are to prevent incontinence (loss of control) or accidental leakage and to allow defecation to occur.. The rectum is very elastic, which allows it to store food residues prior to a bowel movement. But it must also be stiff enough to funnel food residues toward the anus during a bowel movement.. The pelvic floor, located below the rectum, is made up of many different muscles including the puborectalis muscle and the external and internal anal sphincter muscles.. The rectum is surrounded by sensory nerves that detect the filling of the rectum with food residues. This sensation of rectal filling enables us to consciously or unconsciously squeeze the external anal sphincter to prevent incontinence until we can reach a toilet. These sensory nerves are also involved in reflexes that let the sphincter muscles relax during a bowel movement.. Bowel incontinence or accidental leakage ...
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TY - JOUR. T1 - Perineal body length as a risk factor for ultrasound-diagnosed anal sphincter tear at first delivery. AU - Geller, E. J.. AU - Robinson, B. L.. AU - Matthews, C. A.. AU - Celauro, K. P.. AU - Dunivan, G. C.. AU - Crane, A. K.. AU - Ivins, A. R.. AU - Woodham, P. C.. AU - Fielding, J. R.. PY - 2014/5. Y1 - 2014/5. N2 - Introduction and hypothesis: Shortened perineal body (PB) is associated with an increased risk of ultrasound-detected obstetric anal sphincter tear. The objective was to determine if shortened perineal body length (,3 cm) is a risk factor for ultrasound-detected anal sphincter tear at first delivery. Methods: Pregnant nulliparous women were recruited over 18 months. At 35-37 weeks gestation and 6 weeks postpartum perineal body length (PB) was measured and subjects completed quality of life questionnaires. Primary outcome was ultrasound-diagnosed anal sphincter tear at 6 weeks post-partum. Secondary outcomes were also assessed. A priori power analysis determined ...
Rectoanal inhibitory reflex (RAIR) is a physiological modulated reflex involved in anorectal continence and defined by a relaxation of internal anal sphincter following rectal distension. Its existenc
Masaaki Ito, Yuji Nishizawa, Takeshi Sasaki, Akihiro Kobayashi. National Cancer Center Hospital East. Objective: The aim of this study was to clarify the short-term results and surgical tips of down-to-up TME by TAMIS following trans-anal intersphincteric dissection (ISD+TAMIS-TME) for very low rectal cancer near the anus.. Methods: We experienced this procedure in thirty-one C-Stage lower rectal cancers locating within 5cm from the anal verge. In the first step of this procedure, transanal intersphincteric dissection was performed from 2cm distal side of the tumor till the level that the puborectal muscle was fully exposed and then placed Gelpoint path in the anal canal. Distal stump was closed to prevent cancer cell dissemination and irrigate the anal canal. Down-to-up TME was performed under pneumoperitoneum using conventional laparoscopic devices till the level of the peritoneal reflux. Next, we moved to the abdominal side and did conventional laparoscopic procedures to make resection of the ...
Click here for External anal sphincter pictures! You can also find pictures of Fertilization of ovum, Fallopian tubes, Facial vein.
TY - JOUR. T1 - Multicentre study of robotic intersphincteric resection for low rectal cancer. AU - Park, J. S.. AU - Kim, N. K.. AU - Kim, Seon Hahn. AU - Lee, K. Y.. AU - Lee, K. Y.. AU - Shin, J. Y.. AU - Kim, C. N.. AU - Choi, G. S.. PY - 2015/1/1. Y1 - 2015/1/1. N2 - Background There is a lack of information regarding the oncological safety of robotic intersphincteric resection (ISR) with coloanal anastomosis. The objective of this study was to compare the long-term feasibility of robotic compared with laparoscopic ISR. Methods Between January 2008 and May 2011, consecutive patients who underwent robotic or laparoscopic ISR with coloanal anastomosis from seven institutions were included. Propensity score analyses were performed to compare outcomes for groups in a 1 : 1 case-matched cohort. The primary endpoint was 3-year disease-free survival. Results A total of 334 patients underwent ISR with coloanal anastomosis, of whom 212 matched patients (106 in each group) formed the cohort for ...
Adult, Aged, Aged; 80 and over, Anal Canal/*physiopathology, Constipation/*physiopathology, Electromyography, Female, Humans, Male, Middle Aged, Muscle Contraction/*physiology, Muscle Relaxation/*physiology ...
Objective: This work aimed to analyze the association between maternal position at birth in spontaneous deliveries and the occurrence of anal sphincter tears (AST) given the lack of evidence related to the least traumatic birth position. Study design: A total of 7832 vaginal deliveries were included. Vaginal-operative deliveries and deliveries with fundal pressure were excluded. Birth positions on bed, in water, kneeling, and in a squatting position on a low stool were compared. Birth position on bed was considered as the reference group, and a logistic regression analysis adjusting for important fetomaternal parameters was performed. Results: The overall incidence of AST was 1.1%. AST rate was significantly increased in squatting (2.9%) and kneeling (2.1%) positions compared with birth position on bed (1.0%) or in water (0.9%). Logistic regression analysis revealed a significantly higher risk for ASTs in squatting (OR 2.92, CI 95% 1.04-8.18) and in kneeling positions (OR 2.14, CI 95% 1.05-4.37) ...
BioMed Research International is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies covering a wide range of subjects in life sciences and medicine. The journal is divided into 55 subject areas.
Im trying to find information on a rare anal canal cancer. My husband is 57 and has had Perianal Crohns Disease since his early 20s. Has never allowed an illeostomy to be performed. A rare (from what his doctors tell us) cancer was found in his anal canal. The "tumor" itself is actually filled with a gelatinous material which is the cancer, when debulked prior to treatment, the tumor was flat. My husband refused surgery and recently finished chemo/radiation therapy. 6 weeks with the infusion pump (5-FU) and 6 weeks radiation. Just wondering if anyone has infomation on this type of adenocarcinoma they can share. Thanks! ...
Intersphincteric resection (ISR) is a surgical approach that allows resection of low lying rectal cancers that abut or invade the sphincter complex while avoiding the creation of a permanent stoma. While removing a portion of or the entire internal anal sphincter, the goal of therapy is complete extirpation of the cancer while preserving the external sphincter for anastomosis and preservation of continence through the anal canal. The critical considerations revolve around cancer outcomes (local and distant recurrence rates), as well as bowel function/continence. ...
Intersphincteric resection (ISR) is a surgical approach that allows resection of low lying rectal cancers that abut or invade the sphincter complex while avoiding the creation of a permanent stoma. While removing a portion of or the entire internal anal sphincter, the goal of therapy is complete extirpation of the cancer while preserving the external sphincter for anastomosis and preservation of continence through the anal canal. The critical considerations revolve around cancer outcomes (local and distant recurrence rates), as well as bowel function/continence. ...
Surgery, also called surgical resection, involves removing the tumor during an operation. The surgeon removes the area of the colon or rectum containing the tumor as well as nearby tissues and lymph nodes. If possible, the surgeon will then reconnect the healthy sections of the colon or rectum in a process called anastomosis, keeping the bodys waste-removal system operational.. Sometimes the area of anastomosis needs to be bypassed to allow more time for healing and to reduce the risk of a stool leak. This is usually done in the treatment of rectal cancer, especially after being treated with radiation and/or if the connection (or anastomosis) is close to the anal sphincter muscles. In those cases, the surgeon will create an opening in the wall of the abdomen and attach either part of the colon or part of the small intestine to the opening. This procedure is called a colostomy (if the colon is used) or ileostomy (if the small bowel is used), and the opening is called a stoma. A pouch is then ...
If the make and started drugs skuterze kopniakiem. Butt plugs are a great way to explore anal sensations and anal play. My partner and I will soon have anal sex for the first time. I was wanting to make anal sex more pleasurable for my girlfriend so if any one has any. If he cums in your ass, that. The easy way to have painless anal sex. Anal sex is more pleasurable for a man than a woman. The anus has no natural lubricant, so make sure you apply enough for a comfortable experience. However, it doesn't exactly make it easy to have an extended conversation. There is always a risk of contracting HIV or any other STD when having sex or while engaging in risky sexual behaviors. Anal stretching can randomly tear anal sphincter muscle fibers as can aggressive anal sex, leading to variable degrees of incontinence. Before we look at the best anal sex positions, let's explore how to prepare properly for anal sex to make sure that you don't experience any. In order for you to enjoy it fully ...
Grade 3a involves less than 50 % and grade 3b involves greater than 50 % of the EAS. The injury causes J. Gosling and A. Emmanuel a tear in the anterior portion of the muscles which is typically repaired primarily using an end--to--end or overlapping technique. Persisting sphincter defects cause dysfunction due to the mechanical disadvantage of an absent continuous muscular ring. There is much interest into the pathophysiology of incontinence in patients without a structural defect of the external anal sphincter, previously termed idiopathic faecal incontinence. The ability of normal volunteers to retain a saline enema was not hindered; in fact it improved in two cases. Pathophysiology of Anorectal Sensation Baldi et al. and Kamm et al. have shown reduced rectal sensation as tested by balloon and electrical stimulation in some patients with idiopathic constipation [89, 90]. This suggests a sensory neuropathy. This could be within the intrinsic supply within the rectal wall or the extrinsic nerve ...
(KudoZ) English to Russian translation of primary overlap versus end-to-end surgical repair of obstetric anal sphincter in: накладывание первичных швов; сшивание конец в конец [Surgery in Obstetrics - Medical (general) (Medical)].
This drug acts by expanding or dilating the blood vessels of the body which allows for more blood to flow to the heart. These days, they are available in bottles and can be sniffed directly. Isobutyl nitrite gives people a head rush on inhaling and the effects of this drug last a couple of minutes. Many people have reported their orgasms to last for longer periods when they sniffed poppers during sex. Men have reported enhanced erections after sniffing isobutyl nitrite and this could be well due to the increased blood flow in the body. Sometimes this drug is also used to relax the anal sphincter muscle region of a person.. There are a few precautions although which need to be taken before you sniff isobutyl nitrite. The effects of isobutyl nitrite can increase drastically during or immediately after physical exercise such as jogging, dancing, swimming etc. These effects may sometimes give people a slight headache or make them feel sick or weak. All of these effects wear off within a few minutes ...
During the early phases (phases 1 and 2), researchers assess safety, side effects, optimal dosages and risks/benefits. In the later phase (phase 3), researchers study whether the treatment works better than the current standard therapy. They also compare the safety of the new treatment with that of current treatments. Phase 3 trials include large numbers of people to make sure that the result is valid. There are also less common very early (phase 0) and later (phase 4) phases. Phase 0 trials are small trials that help researchers decide if a new agent should be tested in a phase 1 trial. Phase 4 trials look at long-term safety and effectiveness, after a new treatment has been approved and is on the market. ...
The commonest injury to the sphincter complex is obstetric [3]; by disruption at traumatic (forceps) delivery, tearing, or by misplaced episiotomy. If not recognised by the attending obstetrician and...
PURPOSE: Anal pathology occurs in 20 to 80 percent of patients with Crohns disease in which abscesses, fistulas, and fissures account for considerable morbidity. The etiology is not clearly defined, but altered anorectal pressures may play a role. T
Under general anesthesia, the patient was placed in the lithotomy position. The port for the camera was created first at the umbilicus using the open method. Two 5-mm ports were inserted through the right upper and lower quadrants, and the upper port was placed where a diverting stoma would be created. Two needlescopic forceps (Endo-Relief™, Hope Denshi Co.,Chiba, Japan), with or without a trocar, were inserted into the left upper and lower quadrants. Thereafter, we performed the following procedures: ligation of the inferior mesenteric artery (IMA) and inferior mesenteric vein (IMV), dissection of the mesentery, total mesorectal excision with the preservation of the autonomic nerves, and dissection of the intersphincteric space. After transanal intersphincteric dissection, extraction of the specimens, and coloanal anastomosis, the ileostomy covering was created at the right upper port, and the abdominal drain was inserted into the right lower port.. (Results ...
Carcinoma of the anal canal is a rare malignancy representing approximately 2.5% of all gastrointestinal malignancies. It is estimated in 2015 that over 7,200 patients will be diagnosed with carcinoma of the anal canal in the United States, resulting in greater than 1,000 deaths (1). The incidence of this disease continues to rise steadily. A practicing oncologist will evaluate and treat less than one such patient per year. The majority of anal carcinoma arises within the mucosa of the anus and is of squamous cell histology (2). Traditionally, 74% to 90% of carcinomas of the anal canal are cured with the combined modalities of chemoradiation, reserving an abdominoperineal resection (APR) for salvage therapy of persistent or recurrent disease (3). This chapter focuses on treatment of squamous cell carcinoma of the anal canal and the potential innovative strategies that lie ahead. ...
The anal canal is the final segment of the gastrointestinal tract, extending between the rectum and the anus. It has an important role in defecation and maintaining faecal continence.
The dentate line marks the junction of these two structures as the anal canal continues more distally joining the perianal skin at the anal verge (Figure 2). The anal canal mucosa consists of stratified squamous epithelium and contains no hair follicles or sweat glands. At the anal verge, the anoderm thickens and includes hair follicles and other cutaneous appendages. Proximal to the dentate line, the rectal ampulla narrows to conform to the opening of the anal canal. In doing so, its mucosa takes on a pleated appearance, forming 8 to 14 convoluted longitudinal folds: the columns of Morgagni. Each adjacent column is connected at the dentate line by a flap of mucosa that forms a small anal crypt, normally 1 to 3 mm deep. Anal sepsis, cryptitis, perianal abscesses, and fistulas result from inflammation, obstruction, and infection of the crypts and glands. The anal wall is a continuation of the usual layers of the wall of the colon and rectum, and the innermost mucosal lining continues to the anal ...
NO is recognised as an important inhibitory neurotransmitter in the IAS. Previous studies showed that blockade of NO biosynthesis reduced the relaxation of muscle strips of the IAS induced by electrical stimulation and impaired the RAIR.3,5 In the present study, we extended the role of NO as an inhibitory neurotransmitter to the murine IAS: blockade of NO biosynthesis resulted in a reduction of both the in vitro and in vivo relaxation of the IAS. These findings were further corroborated by experiments in nNOS−/− mice. Isolated muscle strips relaxed significantly less whereas the RAIR was impaired compared with controls. It should be emphasised that the IAS still relaxed in nNOS−/− mice and that blockade of NO biosynthesis in controls incompletely reduced electrical stimulation induced relaxation. These observations suggest that either nitrergic blockade was incomplete or, most likely, that another inhibitory neurotransmitter is involved. Previous studies in the rat IAS suggested ATP as a ...
Tried to post on this subject, but somehow didnt take. If its posted *twice somewhere, sorry. * Post edited to add injection to title :) and 2nd ...
Visit Site Ergonomic handles and a specially engineered squeeze motion has made Fiskars Squeeze Punches two times easier to squeeze than other hand punches. An open punch head lets the user see where they are punching for a perfect punch every time without wasting paper and the Squeeze Punches nest together for convenient space-saving storage. Fiskars Squeeze Punches are available in medium, large and extra-large sizes to add distinctive style to craft projects of all kinds. Visit Fiskars.com to see the full line of Squeeze Punches awarded the Ease-of-Use Commendation.. ...
This view is a close-up of the lower part of the dissection illustrated in the preceding photograph and is centered on the anal canal. The canal has been opened by an incision placed laterally through the wall of the canal and connected above with an anterior midline incision through the wall of the rectum. The wall of the anal canal posterior to the incision has been retracted. The mucosa of the anal canal has not been stretched sufficiently to reveal the pectinate line formed by the anal valves at the lower ends of the anal columns. The position of this line is indicated in the drawing at 17 ...
The anal canal has a triradiate lumen lined by three fibrovascular cushions of submucosal tissue. The cushions are suspended in the canal by a connective tissue framework derived from the internal anal sphincter and longitudinal muscle. Within each cushion is a venous plexus that is fed by arteriovenous communications. These specialised vascular structures allow for enlargement of the cushion to maintain fine continence. In health as in disease the anal cushions appear in the right anterior, right posterior, and left lateral positions.3. Fragmentation of the connective tissue supporting the cushions leads to their descent. This occurs with age and the passage of hard stools, which produce a shear force on the framework. Straining produces an increase in venous pressure and engorgement. The prolapsed … ...
The urogenital tract is composed of three organ groups which lie in close proximity within the pelvic cavity: the bladder and urethra; the genital organs (uterus, fallopian tubes, ovaries, vagina and vulva); and the rectum and anal canal. These organs share a common embryologic origin and all possess estrogen receptors.1,2 They rest upon a common support structure--the pelvic diaphragm or levator muscles3--which not only invests each organ with supportive fibres, but also contributes to the mechanisms that maintain urinary and anal continence and close the introitus of the vagina. The urethral and anal continence mechanisms are dependent upon the normal functioning of both smooth and striated muscle sphincters.. ...
Tight Anal Sphincter & X-Ray Abnormal Symptom Checker: Possible causes include Rectal Obstruction. Check the full list of possible causes and conditions now! Talk to our Chatbot to narrow down your search.
Remain with the ease of dissection pill viagra new. The external anal sphincter function. The most common symptoms are fever, rash, and manifest more severe injury and infection of the neck. 6. Be aware that dyspnea, fatigue, muscle atrophy, and dif- culty voiding. The skin incision is deepened through the opqrst mnemonic. A referral to rehabilitation services or a local anesthetic. C. Et al, 44 trani. 197). 7/27 2. 7 weeks depending on the face, neck, and on her altered body image and ineffective gas exchange. Increasingly, it is conned to one lobe of the entire maxilla except the large bore aspiration catheter, a separator, and a large skin island is positioned in the transition to home and bathing equipment. 4. 192). Guidelines for the second stage, higher apgar scores, prone sleeping position, feeding), any illness in western countries, probably because of hemodynamic and clinical history, may provide an adequate airway and breathing. Occasionally diarrhea, if constipation occurs. Establish ...
This page includes the following topics and synonyms: Anorectal Exam, Anorectal Anatomy, Rectal Anatomy, Dentate Line, Pectinate Line, Rectum, Rectum Anatomy, Anal Anatomy, Anorectal Condition, Anorectal Disorder.
The gastrointestinal tract terminates in a short segment, the anal canal. Its external margin is poorly demarcated, but the skin of the anal canal can usually
Spread may occur to the vagina, urethra and anal canal as well. This called local spread. If the cancer has spread to the urinary tract there may be difficulty in urinating. If the cancer has spread to the anal canal there may be problems with bowel motions etc.. Around 5% cases show a more distant spread. This may involve major organs like lungs, liver and brain. The consequences are usually life threatening. Spread to the liver manifests as jaundice and that to the lungs as fluid collection around the lungs and breathlessness. The cancer can also spread to bones causing bone pain and easy fractures.. ...
Aim of the work The present study aimed to declare the commonly and rarely occurred anorectal affections in farm animals as well as the description of their surgical management.
Zhang CH, Wang P, Liu DH, Chen CP, Zhao W, Chen X, Chen C, He WQ, Qiao YN, Tao T, Sun J, Peng YJ, Lu P, Zheng K, Craige SM, Lifshitz LM, Keaney JF, Fogarty KE, ZhuGe R, Zhu MS. The molecular basis of the genesis of basal tone in internal anal sphincter. Nat Commun. 2016 Apr 22; 7:11358 ...
A urethral prosthesis with prostatic and bulbar segments connected by two types of ties allows the prosthesis to assume at least two configurations different with inter-segmental distances adapted to situations where the patient either has or does not have normal control of the external sphincter. This is particularly useful for a patient undergoing an anesthetic procedure that affects the external sphincter muscles. When the muscles are anesthetized, the prosthesis may provide constant urine voiding, and when the anesthetic effects wear off, the prosthesis may assume a different configuration to allow the sphincter to reassert control over urinary voiding.
Anal Abscess is one of the most common types of diseases related to anus and anal canal in which a localized collection of pus develops in the underlying tissues of anus. Anal Abscess is a [...] ...
If the reason of proctologists visit was the strong pain in anal canal or manifest bleeding you should not prepare yourself for examination (in some cases it can be even dangerous for your health).
Back in the day, Marilyn Monroe and Joe DiMaggio were pioneers in the world of celebrity-athlete pairings.Welcome to Squeeze Play, our newest feature on
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The Bank of England s latest credit report is positively menacing. Banks have tightened credit and will tighten more. Consumers are being forced towards unsecured lending. The jaws are closing around the UK economy. Rate cuts seem certain, but not sure to stop the squeeze.
Now, the delicate part is not in the signal module. Trading suspension for example is not a signal issue but a position size one. If sizes are too small, then trades are rejected. For example, sometimes currency pairs flip-flops between bull and bear. So, we count entries and add penalty for each full exit. This reduces risk per trade. If the overall equity is ain a drawdown, then position sizes get smaller. If they are too small, they are automatically rejected. This allows us to trade more pairs as some of them stop trading.. From: Graham. How do you simulate borrowing costs when testing a shorting strategy?. Everything at General Collateral (GC) +0,15% added to slippage. The question is probably related to hard to source issues or crowded shorts.. Do not short issues with borrow ,5%, except on the Long side: squeeze box. Do not squeeze people: it is bad karma. From: Nikhil. 1) Majority of ideas for a short strategies seem to fail rigorous testing on larger time frames so one should focus on ...
Do not pick or squeeze your blackheads and pimples - As tempting as it may be, do not squeeze, scratch, rub or touch your pimples and blackheads.
Rishi Raj is part of Stanford Profiles, official site for faculty, postdocs, students and staff information (Expertise, Bio, Research, Publications, and more). The site facilitates research and collaboration in academic endeavors.
by Drs. Gregory P. Fontana and Raj Makkar , Aug 6, 2009 , Controversies 2009 , 0 comments. The Controversies and Advances in the Treatment of Cardiovascular Disease: The Ninth in the Series symposium will take place October 1-2, 2009 at the beautiful Beverly Hills Hotel. This world-renowned program will offer a realistic view of controversial topics and ...
Mumbai - Indian film production giant Yash Raj Films (YRF) Thursday announced the launch of its official e-commerce store www.yrfstore.com. For starters, i
We talked to experts to find out the scoop behind the famous 7-Minute Workout. Heres how to squeeze the most out of a short training session.
my 3 (or 4 year old) CX-300s died today - Or at least the cable in the left ear peice has finally broke and I cant really just squeeze or bend the cables...
Great-Planes #GPMGPMR6007. The Pro CA Glues are clog-resistant with extra-long applicator tips to easily reach into tight spots. Easy to squeeze bottles aid in applying just the right amount of glue-for easier sanding and less mess. All Great Planes CA glues have a satisfaction guarantee, best if used by date and are clear. Wicks quickly for instant bonds on tight-fitting parts, tacking and CA hinges ...
22 comments? Man, nothing empties the pews like passing the plate, huh?. I did Jan/Damon plus Redvolution on day one, but if the deadbeats dont pay up by 7/15 Im going to try to squeeze out another Grant…any others that can, please do.. ...
The Home and Garden Show is coming to Weekends Only Furniture and Mattress for their grand opening on the southside of Indy. Pat and Denny will be there to bring you their mix of education and entertainment.
yo͞ong´gäs [key], region of lowland valleys in the eastern piedmont of the Andes Mts., 5,000-8,000 ft (1,524-2,438 m) high, extending from the Peru-Bolivia border SE into central Bolivia. They receive excessive rainfall and are warm and humid.
TY - JOUR. T1 - Risk factors for the recurrence of obstetrical anal sphincter injury and the role of a mediolateral episiotomy. T2 - an analysis of a national registry. AU - van Bavel, J.. AU - Ravelli, A. C.J.. AU - Abu-Hanna, A.. AU - Roovers, J. P.W.R.. AU - Mol, B. W.. AU - de Leeuw, J. W.. N1 - © 2020 Royal College of Obstetricians and Gynaecologists.. PY - 2020/4/3. Y1 - 2020/4/3. N2 - Objective: The assessment of risk factors, including mediolateral episiotomy (MLE), for the recurrence of obstetric anal sphincter injury (rOASI). Design: Population-based cohort study. Setting: Data from the nationwide database of the Dutch Perinatal Registry (Perined). Population: A cohort of 391 026 women at term, of whom 9943 had an OASI in their first delivery and had a second vaginal delivery of a liveborn infant in cephalic position. Methods: Possible risk factors were tested for statistical significance using univariate and multivariate logistic regression analysis. Main outcome measures: Rate of ...
The external anal sphincter (or sphincter ani externus ) is a flat plane of muscular fibers, elliptical in shape and intimately adherent to the skin surrounding the margin of the anus. The external anal sphincter measures about 8 to 10 cm in length, from its anterior to its posterior extremity, and is about 2.5 cm opposite the anus, when defecation occurs the sphincter muscle retracts. It consists of two strata, superficial and deep. The superficial, constituting the main portion of the muscle, arises from a narrow tendinous band, the anococcygeal raphe, which stretches from the tip of the coccyx to the posterior margin of the anus; it forms two flattened planes of muscular tissue, which encircle the anus and meet in front to be inserted into the central tendinous point of the perineum, joining with the superficial transverse perineal muscle, the levator ani, and the bulbospongiosus muscle also known as the bulbocavernosus. The deeper portion forms a complete sphincter to the anal canal. Its ...
Looking for online definition of anal canal in the Medical Dictionary? anal canal explanation free. What is anal canal? Meaning of anal canal medical term. What does anal canal mean?
Lateral Internal Sphincterotomy What is a lateral internal sphincterotomy? A lateral internal sphincterotomy is a procedure to treat anal fissures. What is an anal fissure? An anal fissure is a t...
RESULTS: The study population included 2 570 847 deliveries. Episiotomy use declined significantly among operative vaginal deliveries (53.1% in 2004 to 43.2% in 2017, p , 0.0001) and spontaneous vaginal deliveries (13.5% in 2004 to 6.5% in 2017, p , 0.0001). Episiotomy was associated with higher rates of obstetric anal sphincter injury among spontaneous vaginal deliveries (4.8 with episiotomy v. 2.4% without; adjusted rate ratio [RR] 2.06, 95% confidence interval [CI] 2.00-2.11) and this association remained after stratification by parity and obstetric history. In contrast, episiotomy was associated with lower rates of obstetric anal sphincter injury among forceps deliveries in nulliparous women (adjusted RR 0.63, 95% CI 0.61-0.66), and women with vaginal birth after cesarean (adjusted RR 0.71, 95% CI 0.60-0.85), but not among parous women without a previous cesarean (adjusted RR 1.16, 95% CI 1.00-1.34). ...
TY - JOUR. T1 - Obstetric sphincter injury interacts with diarrhea and urgency to increase the risk of fecal incontinence in women with irritable bowel syndrome. AU - Robinson, Barbara L.. AU - Matthews, Catherine A.. AU - Palsson, Olafur S.. AU - Geller, Elizabeth. AU - Turner, Marsha. AU - Parnell, Brent. AU - Crane, Andrea. AU - Jannelli, Mary. AU - Wells, Ellen. AU - Connolly, AnnaMarie. AU - Lin, Feng Chang. AU - Whitehead, William E.. PY - 2013/1/1. Y1 - 2013/1/1. N2 - Objectives: This study aimed to confirm that fecal urgency and diarrhea are independent risk factors for fecal incontinence (FI), to identify obstetrical risk factors associated with FI in women with irritable bowel syndrome, and to determine whether obstetric anal sphincter injuries interact with diarrhea or urgency to explain the occurrence of FI. Methods: The study is a supplement to a diary study of bowel symptoms in 164 female patients with irritable bowel syndrome. Subjects completed daily bowel symptom diaries for 90 ...
Dr. Zadeh responded: Sphincterotomy. Surgery is usually recommended for patients who have not healed their fissure after at least three months of medical therapy. Surgical treatment for anal fissures is highly effective and recurrence is low. The procedure is called a lateral internal sphincterotomy and involves cutting a portion of the internal anal sphincter muscle. This helps the fissure heal and decreases pain and spasm.
Faecal incontinence (FI) is a debilitating and often neglected problem. It can be defined as the loss of voluntary control of liquid or solid stool.It is estimated that 2-3% of western adults suffer from FI with prevalence increasing with age, further to this up to 50% of nursing home residents suffer too with it more common in females. Aetiology is often multi-factoral, where obstetric anal sphincter injury is most common is females and iatrogenic anal sphincter injury is most common in males.. Loperamide (imodium) is a constipating agent used as first choice pharmacological agent due to its high efficacy. Trials have suggested it thickens stool consistency and may raise resting anal sphincter pressure, associated with improved clinical function with a reduction in bowel frequency and urgency, a reduction in incontinence and less need for pads.. Loperamide is well tolerated but has been known to cause side effects of abdominal pain and distension, nausea and vomiting and constipation.. Imodium ...
Full text available only in PDF format". REFERENCES. 1. Thornton MJ, Lam A, King DW. Laparoscopic or transanal repair of rectocele? A retrospective matched cohort study. Dis Colon Rectum 2006;49:661-667.. 2. Dietz HP, Steensma AB. Posterior compartment prolapse on two-dimensional and three-dimensional pelvic floor ultrasound: the distinction between true rectocele, perineal hypermobility and enterocele. Ultrasound Obstet Gynecol 2005;26:73-77.. 3. Perniola G, Shek C, Chong CC, Chew S, Cartmill J, Dietz HP. Defecation proctography and translabial ultrasound in the investigation of defecatory disorders. Ultrasound Obstet Gynecol 2008;31:567-571.. 4. Cronje HS. Colposacrosuspension for severe genital prolapse. Int J Gynecol Obstet 2004;85:30-35.. 5. Cronje HS, De Beer JAA. Culdocele repair in female pelvic organ prolapse. Int J Gynecol Obstet 2008;100:262-266.. ...
Transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS) are similar techniques that allow surgeons to remove benign polyps and early stage cancers without the use of invasive surgery.. More about TEM. Developed in the 1980s, TEM was created to enable surgeons to remove polyps and tumors in the rectum using a port placed through the rectum and a microscopic lens. This technology has demonstrated precise excision of polyps and tumors with preservation of anal sphincter muscle control.. More about TAMIS. TAMIS was developed in 2009 and has been utilized for the same indications as TEM.. What is the difference between TEM and TAMIS? The primary difference between the two techniques is that a resterilized, reusable port is used for TEM, while a disposable port is used for TAMIS.. What are the benefits of TEM and TAMIS?. Many benefits have been noted for patients undergoing TEM and TAMIS: no visible incisions, decreased postoperative pain, faster recovery, and a ...
A. The rectum is empty. There is no urge to defecate.. B. Stool enters the rectum and stretches the rectal wall, causing a sensation of fullness.. C. Rectal wall distention causes relaxation of the internal anal sphincter, allowing the stool to descend into the proximal anal canal. This movement causes awareness that stool passage is imminent.. D. The pelvic floor muscles contract to maintain continence, moving the stool upward and out of the anal canal.. E. If the stool remains in the rectum after the pelvic floor returns to its resting state, then stool will no longer be in contact with the anus. The rectal wall relaxes; reducing the pressure and wall tension, and the urge to defecate abates.. F. Defecation occurs when the pelvic floor relaxes, and the pressure in the rectum is greater than pressure from the external anal sphincter and the pelvic floor. Stool moves from the region of higher pressure to the area of lower pressure. The accompanying increase in intra-abdominal pressure propels ...
In some cases, surgery can damage the anal sphincter muscles (the ring of muscles that open and close the anus). If the muscles are damaged, you may lose control of your bowels, leading to faeces leaking uncontrollably from your rectum (the area where they are stored). This is known as faecal or bowel incontinence.. The likelihood of incontinence occurring after surgery will depend on the type of surgery you had and the position of your fistula. If you had some bowel incontinence before surgery, this may get worse.. Incontinence after a fistulotomy (surgery that opens up the fistula) is more common in women and in people with Crohns disease, a condition that causes inflammation of the lining of the digestive system. Rates of incontinence vary, although most studies report incontinence in between 3% and 7% of people.. After using seton techniques, the incontinence rate is 17%, and after an advancement flap procedure the incontinence rate is around 6-8%. Ask your Dr. B C Shah about the risks ...
Internal sphincter muscle of anus definition at Dictionary.com, a free online dictionary with pronunciation, synonyms and translation. Look it up now!
Most patients who cannot have a J- or S-pouch will have a permanent ileostomy bag. However, the Kock pouch, or K-pouch, is an alternative to a regular (end) ileostomy. The K-pouch is used in cases of ulcerative colitis when the large intestine and rectum need to be removed because of disease and the anal sphincter muscles are weak, or because a J- or S-pouch cannot or should not be made.. About 16 inches (40 cm) of the last portion of the small intestine are used to build an internal reservoir, which is then attached to the inside of the abdominal wall. A small opening called a stoma leads out and is used several times a day to drain waste matter through a catheter (tube) inserted into the K-pouch.. Three loops of the small intestine, each about 12 inches long (about 30 cm), are stitched or stapled together to form the pouch. Another length of intestine, approximately 4 inches (about 10 cm), is used to make a valve or "nipple" between the stoma and the pouch. The nipple acts as a flap valve to ...
The most recent estimates, and statistics show that the future of cold and flu, most people visit their doctors, because it hurts the various parts of the body. While it is normal to come back pains after -particularly aches- a stressful or hectic day exercise, back pain is often a result of constipation. Other causes pain to the back of stress, excessive walking, degenerative disc disease, climbing stairs, bending, heavy lifting and standing for long periods. If the above-mentioned non-common part of daily activities, and then constipation, it is likely that there are a bout of back pain and constipation. Straining to pass hard stool can cause pain in the lower back. It hurts happens because the anus and inflamed because of the stress put on it when trying to defecate. Children are also known to suffer from these problems. Parents have been known to their children to the doctor to help diagnose a pain only to find that the child suffers from pain caused by tension in the anal sphincter muscle ...
inproceedings{243807, author = {De Looze, Danny and De Muynck, Martine and Van Laere, Myriam and Tahmaseb, E and De Bie, S and Elewaut, Andr{\e}}, booktitle = {GASTROENTEROLOGY}, issn = {0016-5085}, language = {eng}, number = {4, suppl.}, pages = {A485--A485}, title = {Anorectal function in patients with spinal cord injury: a manometric study}, volume = {106}, year = {1994 ...
Dont be a tight-ass. The thoracic diaphragm has anatomical and neurological connections to the pelvic floor via the levator ani muscle group. There will not be a quiz, but know that when this section of the pelvic floor contracts it tucks the tail bone (coccyx) under. That predisposes the lumbar spine to round backwards which sets the dominos in motion to slump which compromises ideal respiratory function. Know that this action may also reflect a guarded/emotional environment. Some individuals never let go. I had a patient who had habituated to this action and subsequently it was discovered that when they were able to release their fear of spontaneous evacuation and relax their external sphincter much of their back pain resolved ..Note: there are two anal sphincters; the internal sphincter, comprised of smooth muscle is controlled involuntarily via autonomic mechanisms (thank goodness). It keeps stuff in..most of the time. The external anal sphincter, comprised of striated muscle is ...
PURPOSE: To compare GI symptoms, measures of generic and disease specific health related quality of life (HRQoL), anorectal and pudendal nerve function and anal sphincter morphology between (i) patients ≥2 years after 3D conformal radiotherapy (3D-CRT)±high dose rate (HDR) brachytherapy for carcinoma of the prostate and aged matched patients before radiotherapy and (ii) symptomatic and asymptomatic patients ≥2 years after 3D-CRT ± HDR brachytherapy. MATERIAL AND METHODS: Methodology included: (i) modified LENT-SOMA scales for GI symptoms, (ii) EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires for generic and disease specific HRQoL, (iii) anorectal manometry and terminal motor latency for anorectal and pudendal nerve function and (iv) endorectal ultrasound for anal sphincter morphology ...
We studied 386 anal cancers to examine the association between HPV status and histopathological characteristics in detail. Overall, we detected hrHPV in 90% of invasive anal cancers in women and 63% of those in men. Using in situ hybridization and HPV-16-specific PCR in 99 patients, Holm et al. (9) found HPV in similar proportions of anal canal cancers in women (89%) and men (56%). Another study of 93 women and 36 men with in situ or invasive anal cancer showed 70% of the tumors in women and 67% of those in men to be PCR positive to one or more of HPV-6, -11, -16, and -18, but a distinction between anal canal cancers and perianal skin cancers was not presented (8) .. Whether cancers involving the anal canal contain HPV more often than perianal skin cancers has been the subject of only few investigations. One study reported more HPV-16 in cancers originating above than below the dentate line (17 , 18) , and another small study detected HPV-16 by DNA in situ hybridization in 81% of anal canal ...
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Atlas of Endoanal and Endorectal Ultrasonography: Staging and Treatment Options for Anorectal Cancer by Giulio A Santoro starting at $313.24. Atlas of Endoanal and Endorectal Ultrasonography: Staging and Treatment Options for Anorectal Cancer has 2 available editions to buy at Alibris
MeSH-minor] Adult. Aged. Aged, 80 and over. Anal Canal / physiology. Carcinoma in Situ / pathology. Carcinoma in Situ / radiotherapy. Carcinoma in Situ / surgery. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Carcinoma, Transitional Cell / pathology. Carcinoma, Transitional Cell / radiotherapy. Carcinoma, Transitional Cell / surgery. Chi-Square Distribution. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Radiotherapy ...
HOUSTON -- In patients with anal canal carcinoma, a rare malignancy, cisplatin-based induction therapy did not pan out, a randomized trial revealed.
Use of chemotherapy with the drug cisplatin before other treatments did not improve disease-free survival for patients with anal canal cancer compared to the standard treatment regimen.
Caused by trauma to the anus and anal canal due to bowel movement, anal fissure is a cut or tear occurring in the anus that extends up into the anal canal. Anal fissures are fairly common in men as well as women and can occur at any age including infancy. Symptoms of fissures include the patient suffering from anal pain that worsens with bowel movements. This pain may be bearable or severe in some cases. Sometimes the pain can also affect urination and cause discomfort while urinating, inability to urinate or frequent urination. To suggest an appropriate fissures treatment the doctor needs to first diagnose and evaluate the problem. This means the doctor will inspect the anus to confirm the presence of a fissure before suggesting a mode of treatment.. The goal of any anal fissures treatment is to break the cycle of spasm of the anal sphincter and discontinue its repeated tearing of the anoderm. In the case of acute anal fissures a large percentage of patients show speedy recovery and relief from ...
Find the best faecal incontinence doctors in Gurgaon. Get guidance from medical experts to select faecal incontinence specialist in Gurgaon from trusted hospitals - credihealth.com
Caused by trauma to the anus and anal canal due to bowel movement, anal fissure is a cut or tear occurring in the anus that extends up into the anal canal. Anal fissures are fairly common in men as well as women and can occur at any age including infancy. Symptoms of fissures include the patient suffering from anal pain that worsens with bowel movements. This pain may be bearable or severe in some cases. Sometimes the pain can also affect urination and cause discomfort while urinating, inability to urinate or frequent urination. To suggest an appropriate fissures treatment the doctor needs to first diagnose and evaluate the problem. This means the doctor will inspect the anus to confirm the presence of a fissure before suggesting a mode of treatment.. The goal of any anal fissures treatment is to break the cycle of spasm of the anal sphincter and discontinue its repeated tearing of the anoderm. In the case of acute anal fissures a large percentage of patients show speedy recovery and relief from ...
Learn about the congenital birth defect called anorectal malformation including the causes, symptoms, diagnosis and treatment from St. Louis Childrens Hospital.
AIM Anorectal varices are an uncommon, but significant, source of bleeding in patients with portal hypertension. The aim of this article was to review systematically the available literature on the aetiology, clinical presentation and management of anorectal varices, and to suggest a simple treatment algorithm based on available evidence and local expertise. METHOD A systematic literature search was carried out to identify articles on anorectal varices, and the search strategy identified 57 relevant references. The inclusion criteria included a consecutive cohort of patients having treatment for anorectal varices with details of success rates and the number of different techniques used. Exclusion criteria included papers published in languages other than English with no English version and results not reported separately for anorectal varices. RESULTS Anorectal varices can occur in up to 89% of patients with portal hypertension, although the overall incidence in the general population is low.
RESULTS: The mean time to pain relief was 8.45 (standard deviation (SD) 7.41) days in group 1 and 7.20 (SD 7.19) days in group 2. Healing took place in a mean of 5.20 (SD 1.85) weeks in group 1 and 5.40 (SD 2.01) weeks in group 2. Fissures failed to heal in 2 patients in group 1 and 3 in group 2, and recurred in 4 patients in group 1 and 3 in group 2 ...
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Movement through the bowels is ongoing. From the time of swallowing, the small muscles in the gut walls contract and relax in a rhythmic manner to push along food and wastes through the gut. This rhythmic movement is known as peristalsis. It continues all the way down the gastrointestinal tract to the large intestine to ensure that food and wastes are constantly moving. In the lowest parts of the gut, strong peristaltic contractions pushes out feces during a bowel movement.. With a sluggish bowel, the defecation reflexes and colonic motility are impaired and it leads to constipation. This means that the stretching of the colon wall associated with distension does not elicit the reflexes that are responsible for propelling the colonic contents or relaxing the internal anal sphincter. Defecation reflexes associated with food entering the stomach or chyme in the duodenum may also not stimulate mass movements in the colon under normal circumstances.. Eventually the accumulation of fecal matter ...
Treatments for Fecal Incontinence Certain medications may be able to help relieve your symptoms, depending on the cause of your fecal incontinence. Medical options include anti-diarrheal drugs, if diarrhea is the cause, laxatives, if constipation is the cause, and other medications make be taken to reduce the spontaneous motion of your bowel. Stool consistency is affected by what you eat and drink. Your doctor may suggestion that you drink more fluids and eat more fiber-rich food to bulk up your stools and make them less watery. There are some exercises and therapies that can restore muscle strength if that is the cause of your fecal incontinence. These treatments can improve anal sphincter control and the awareness of the urge to defecate. ...
Treatments for Fecal Incontinence Certain medications may be able to help relieve your symptoms, depending on the cause of your fecal incontinence. Medical options include anti-diarrheal drugs, if diarrhea is the cause, laxatives, if constipation is the cause, and other medications make be taken to reduce the spontaneous motion of your bowel. Stool consistency is affected by what you eat and drink. Your doctor may suggestion that you drink more fluids and eat more fiber-rich food to bulk up your stools and make them less watery. There are some exercises and therapies that can restore muscle strength if that is the cause of your fecal incontinence. These treatments can improve anal sphincter control and the awareness of the urge to defecate. ...
Colonic J-pouch is a type of neorectum, performed during surgery for rectal cancer. This may improve the quality of life of patients over a straight end-to-end anastomosis by forming a reservoir for faeces with patients experiencing less urgency ...