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Management of benign anorectal disorders is challenging for the treating surgeons as the patients are highly distressed, the symptoms are always alarming, and surgical intervention may be associated with lifelong disabilities such as loss of sphincter control. Written by highly experienced colorectal surgeons, this book provides detailed notes on optimal management of these disorders including pre- and post-operative management. Chapters cover the entire range of benign disorders such as hemorrhoids, fissure, fistula-in-ano, anorectal injuries, anal incontinence, rectal prolapse, pelvic floor disorders, benign tumors and ulcers, and strictures. Chapters on surgical anatomy and physiology equip the surgeons with the information necessary to understand the complex anatomy and functioning of this region which makes surgery all the more difficult. Benign Anorectal Disorders is an essential reading for colorectal surgeons, general surgeons, fellows-in-training and the post-graduate students.
Three-dimensional endoanal ultrasonography with emphasis on the anatomy of the pelvic floor and diagnosis of anorectal benign diseases. Numerous schematic representations coupled with ultrasonographic and radiologic images provide a didactic approach. Readers gain a clear understanding of the fundamental principles and techniques of ultrasonography as well as of the normal anatomy of the pelvic floor and its modification in various benign anorectal diseases. Both general and specialist clinical practices will benefit from this book.
Anorectal Disorders: Diagnosis and Nonsurgical Treatments incorporates the most recent major advances in the understanding of anal and rectal anatomy to provide clinical evidence of care for those suffering from anorectal disorders. By condensing basic and practical aspects in the knowledge of anorectal disorders, this book provides a comprehensive review of the anatomy and physiology of the anorectal region. It includes new technology that expands and modifies current perceptions about the functional anatomy of the anorectal region and ultimately impacts how we conceive muscle and nerve structures functioning together to maintain fecal continence and properly execute the process of defecation. Perfect for medical researchers, gastroenterologists, general practitioners, internal medicine doctors and general surgeons, this title will provide diagnosis and treatment options for all patients suffering from anorectal disorders. - Identifies frequent, but not well understood, anorectal disorders, including ulcers, constipation, dyssynergic defecation, tumors and malformations - Condenses the basic and practical aspects of anorectal disorders for better treatment of patients - Includes clinical cases that summarize chapter content in a clinical context
- With a dramatic increase in knowledge of anorectal physiology and imaging over the last five years, this book provides a comprehensive study of anorectal assessment. - Explores all the lastest techniques and treatments in the field - Organized into two, easy to manage, sections - First book to pull a diverse area together and includes 3-D ultrasound, transperineal ultrasonography and dynamic MRI not found in other texts on anorectal disorders
This is the first comprehensive book exclusively dedicated to anorectal physiology and the importance of diagnostic tools in guiding the evaluation and treatment of anorectal dysfunction. Functional disorders, and specifically fecal incontinence and evacuatory disorders, are prevalent in the general population, affecting up to 20% of individuals. As many of these conditions have extremely complex mechanisms, a thorough understanding of anorectal physiology is a crucial element in the surgeon’s “arsenal" to ensure accurate evaluation and to inform treatment. At this time, there is no other title that specifically addresses all aspects of anorectal physiology, as well as anorectal and pelvic floor disorders, including fecal incontinence and defecation disorders. Specifically, the book provides detailed descriptions of diagnostic methods and treatment algorithms for a range of anorectal conditions, including modern treatment modalities such as sacral neuromodulation. A unique and comprehensive reference covering all aspects of the evaluation and treatment of anorectal disorders, Anorectal Physiology – A Clinical and Surgical Perspective will be of significant interest to proctologists and coloproctologists, gastroenterologists, colorectal surgeons, gynecologists and all other professionals interested in anorectal physiology.
As aging trends in the United States and Europe in particular are strongly suggestive of increasingly older society, it would be prudent for health care providers to better prepare for such changes. By including physiology, disease, nutrition, pharmacology, pathology, radiology and other relevant associated topics, Geriatric Gastroenterology fills the void in the literature for a volume devoted specifically to gastrointestinal illness in the elderly. This unique volume includes provision of training for current and future generations of physicians to deal with the health problems of older adults. It will also serve as a comprehensive guide to practicing physicians for ease of reference. Relevant to the geriatric age group, the volume covers epidemiology, physiology of aging, gastrointestinal physiology, pharmacology, radiology, pathology, motility disorders, luminal disorders, hepato-biliary disease, systemic manifestations, neoplastic disorders, gastrointestinal bleeding, cancer and medication related interactions and adverse events, all extremely common in older adults; these are often hard to evaluate and judge, especially considering the complex aging physiology. All have become important components of modern medicine. Special emphasis is be given to nutrition and related disorders. Capsule endoscopy and its utility in the geriatric population is also covered. Presented in simple, easy to read style, the volume includes numerous tables, figures and key points enabling ease of understanding. Chapters on imaging and pathology are profusely illustrated. All chapters are written by specialists and include up to date scientific information. Geriatric Gastroenterology is of great utility to residents in internal medicine, fellows in gastroenterology and geriatric medicine as well as gastroenterologists, geriatricians and practicing physicians including primary care physicians caring for older adults.
The ASCRS Textbook of Surgery of the Colon and Rectum offers a comprehensive textbook designed to provide state of the art information to residents in training and fully trained surgeons seeking recertification. The textbook also supports the mission of the ASCRS to be the world’s authority on colon and rectal disease. The combination of junior and senior authors selected from the membership of the ASCRS for each chapter will provide a comprehensive summary of each topic and allow the touch of experience to focus and temper the material. This approach should provide the reader with a very open minded, evidence based approach to all aspects of colorectal disease. Derived from the textbook, The ASCRS Manual of Surgery of the Colon and Rectum offers a “hands on” version of the textbook, written with the same comprehensive, evidence-based approach but distilled to the clinical essentials. In a handy pocket format, readers will find the bread and butter information for the broad spectrum of practice. In a consistent style, each chapter outlines the condition or procedure being discussed in a concise outline format – easy to read, appropriately illustrated and referenced.
Filled with over 300 detailed illustrations, this text is "gold standard" for information on disorders of the anus and rectum. This 2nd Edition has been extensively revised and updated to include new chapters on minimally invasive surgery, physiologic testing and nursing considerations. The only book devoted totally to the subject, it is the definitive work on anorectal surgery.
Three distinct types of contractions perform colonic motility functions. Rhythmic phasic contractions (RPCs) cause slow net distal propulsion with extensive mixing/turning over. Infrequently occurring giant migrating contractions (GMCs) produce mass movements. Tonic contractions aid RPCs in their motor function. The spatiotemporal patterns of these contractions differ markedly. The amplitude and distance of propagation of a GMC are several-fold larger than those of an RPC. The enteric neurons and smooth muscle cells are the core regulators of all three types of contractions. The regulation of contractions by these mechanisms is modifiable by extrinsic factors: CNS, autonomic neurons, hormones, inflammatory mediators, and stress mediators. Only the GMCs produce descending inhibition, which accommodates the large bolus being propelled without increasing muscle tone. The strong compression of the colon wall generates afferent signals that are below nociceptive threshold in healthy subjects. However, these signals become nociceptive; if the amplitudes of GMCs increase, afferent nerves become hypersensitive, or descending inhibition is impaired. The GMCs also provide the force for rapid propulsion of feces and descending inhibition to relax the internal anal sphincter during defecation. The dysregulation of GMCs is a major factor in colonic motility disorders: irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and diverticular disease (DD). Frequent mass movements by GMCs cause diarrhea in diarrhea predominant IBS, IBD, and DD, while a decrease in the frequency of GMCs causes constipation. The GMCs generate the afferent signals for intermittent short-lived episodes of abdominal cramping in these disorders. Epigenetic dysregulation due to adverse events in early life is one of the major factors in generating the symptoms of IBS in adulthood.