PFD Week 2018-Multi-disciplinary Defecation Disorders

Video Transcription

Video Summary

Dr. Hall discusses treatment for constipation from a colorectal viewpoint in a video presentation. He begins by highlighting the difference between pelvic and abdominal constipation and emphasizes the complexity of pelvic constipation. He assumes that the patients being discussed have failed non-surgical therapy. He then discusses the diagnostic process of determining whether a patient has abdominal or pelvic constipation and the tests that are typically used for each. He also mentions the most common surgical treatment for abdominal constipation, laparoscopic colectomy and iliorectal anastomosis, and shares information on the success rate and patient satisfaction of this procedure. <br /><br />Dr. Hall then delves into the topic of pelvic evacutory constipation, discussing the testing methods used to diagnose and assess this condition, such as video defecography and anal physiology. He explains the role of these tests and how they help in determining appropriate treatment options. He also touches on the topic of Hirschsprung's disease, explaining that it can sometimes be missed in patients until later in life and that a proctectomy and coloanal anastomosis is a successful treatment for these cases. Dr. Hall mentions that rectoceles are typically referred to urogynecologists for treatment. He then focuses on other pelvic conditions such as energetic seal and sigmoid seal and explains how these can be identified through physical examination and radiological testing. He discusses treatment options such as sacro-culpoplexy and sigmoid resection for these conditions.<br /><br />Lastly, Dr. Hall discusses hyposensitivity as a type of constipation and treatment options including sacral nerve stimulation and stoma placement. He emphasizes the importance of conservative therapy as a first-line treatment and the need for proper evaluation and patient selection in order to achieve success in treating constipation. The video concludes with a presentation by a physical therapist, Cindy, who discusses the role of biofeedback therapy in managing pelvic and rectal issues. The presentation includes information on assessment techniques, exercises, and other treatment modalities used by physical therapists. The presentation also mentions the use of electrical stimulation, ultrasound, and various other techniques for treating constipation and fecal incontinence.

Asset Subtitle

Tracy L. Hull, MD, Adil Bharucha, MD, & Cindy Furey, PT, CEO

Keywords

constipation

colorectal viewpoint

laparoscopic colectomy

pelvic evacutory constipation

Hirschsprung's disease

sacro-culpoplexy

biofeedback therapy