Rectal prolapse, rectal intussusception, rectocele, solitary rectal ulcer syndrome, and enterocele.
Rectal prolapse is best diagnosed by physical examination and by having the patient strain as if to defecate; a laparoscopic rectopexy is the preferred treatment approach. Intussusception is more an epiphenomena than a defecatory disorder and should be managed conservatively. Solitary rectal ulcer syndrome is a consequence of chronic straining and therapy should be aimed at restoring a normal bowel habit with behavioral approaches including biofeedback therapy. Rectocele correction may be considered if it can be definitively established that it is a cause of defecation disorder and only after conservative measures have failed. An enterocele should only be operated when pain and heaviness are predominant symptoms and it is refractory to conservative therapy.
Felt-Bersma
Richelle J F
RJ
Department of Gastroenterology, University Hospital "Vrije Universiteit," PO Box 7057, 1007 MB Amsterdam, The Netherlands. rjf.felt@vumc.nl
Tiersma
E Stella M
ES
Stella
M Tiersma E
MT
Cuesta
Miguel A
MA
D005260:Female; D006547:Hernia / Q000175:diagnosis / Q000209:etiology; D059685:Herniorrhaphy; D006801:Humans; D007443:Intussusception / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012005:Rectal Prolapse / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D020047:Rectocele / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013577:Syndrome; D014456:Ulcer / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*