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Diagnostic Tests for Defecation Disorders

  • Peter Christensen
Chapter
Part of the Urodynamics, Neurourology and Pelvic Floor Dysfunctions book series (UNPFD)

Abstract

Diagnostic test for disordered defecation should only be considered in case of failure of initial treatment initiatives and before more invasive treatment modalities are introduced. Physical examination is restricted to inspection, and digital rectal examination should only be performed in very selected cases to rule out secondary causes preferably under general anaesthesia. Transcutaneous ultrasonography of the rectum offers a non-invasive assessment of faecal impaction. Colonic transit time by the use of radiopaque markers and a subsequent plain abdominal X-ray correlates with both symptoms and bowel frequency and offer useful guidance for further treatment adjustments. In rare cases, full thickness rectal biopsies without ganglion cells and the absence of the manometric rectoanal inhibitory reflex is diagnostic for Hirschsprung’s disease. Anorectal manometry, investigation of rectal motility and advanced motility may have a role in future paediatric gastroenterology.

Keywords

Constipation Faecal impaction Faecal incontinence Perineal inspection Digital rectal examination Anorectal manometry Rectal biopsy Hirschsprung’s disease Ultrasonography Colonic transit time 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pelvic Floor Unit, Department of SurgeryAarhus University HospitalAarhusDenmark

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