Rectal Evacuatory Dysfunction:An Overview of Causes, Consequences and Cures

Bandipalyam V Praveen

doi:10.21767/2575-7733.1000008

Abstract

Evacuatory Dysfunction is difficulty in emptying the rectum which may occur even with frequent visits to the toilet and/ or passing soft motions “. An alternative definition for evacuatory dysfunction is a constellation of symptoms such as prolonged repeated straining at bowel movements, sensation of incomplete evacuation, and the need for digital manipulation.

Highlights

Evacuatory Dysfunction is "difficulty in emptying the rectum which may occur even with frequent visits to the toilet and/ or passing soft motions “
It is to be remembered that these problems have a long natural course which are influenced by multiple factors
A percutaneous method (PTNS) or Sacral Nerve Stimulation (SNS) may be used. These are mainly useful in the management of Obstructed Defaecation Syndrome (ODS) due to mechanical issues such as Rectocoele, Enterocoele, Rectal Intussusception and Rectal Prolapse

Summary

Introduction

Evacuatory Dysfunction is "difficulty in emptying the rectum which may occur even with frequent visits to the toilet and/ or passing soft motions “. The third one is the need for the tooth-paste to be present in adequate amounts and consistency to come out – which equates with the need for stools with optimum consistency to have been delivered to the rectum Another useful comparison to describe the role of the different groups of muscles during evacuation is to describe it in terms of a ‘doubles tennis match’. The reduced rectal sensation (Hyposensitivity) will lead to increased rectal loading, megarectum, incomplete emptying due to both inadequate feedback and deranged local reflexes These can lead to secondary consequences like Rectocoele and Rectal intussusceptions and tertiary problems like urgency, faecal incontinence and haemorrhoids. © Copyright iMedPub | This article is available from: http://www.imedpub.com/clinical-gastroenterology-and-hepatology/ Various systemic factors such as Systemic Sclerosis, dementia, Ehlers Danlos syndrome, learning disabilities, and medications can affect the evacuation process. Validated questionnaires which can help in planning treatments for the symptomatic patients

Consequences of Rectal Evacuatory Dysfunction

Broad principles of management

Role of investigations

Surgical treatments

Conclusion