Dyssynergia
Dyssynergia |
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Dyssynergia is any disturbance of
Dyssynergia can be caused by disruption or damage between the
In addition, most brain damage to the
Types
Ramsay Hunt syndrome type 1
Bladder sphincter dyssynergia
Anal sphincter dyssynergia
Diagnosis
Anal sphincter dyssynergia
Anorectal manometry
Anorectal manometry involves two separate tests: the balloon expulsion test and anal sphincter electromyography (EMG). These tests are performed in order to properly identify and diagnose dyssynergia. In order to prepare for these tests, a patient must fast and perform specific enemas recommended by their doctor two hours before their tests. When undergoing the balloon expulsion test, the patient has a small balloon inserted into their rectum, which is then inflated and filled with water. The patient is then instructed to go to the nearest bathroom and to attempt to defecate the balloon, where the time it takes is recorded by the doctors. An abnormal or prolonged time of expulsion of the balloon is seen as a problem in the anorectum region of the body and may lead to the diagnosis of dyssynergia, since the patient has a lack of control over their anorectal muscle contractions. Another technique used by doctors to test for dyssynergia is the anal sphincter EMG. This test involves the insertion of an electrode into the patient’s anal cavity, where they are asked to relax and push, as if they are trying to defecate. The electrical activity and contractile pressures of the patient’s anorectal contractions are recorded on a computer monitor and examined by the doctor. If the electrical activity of the contractions appear normal, but the patient still results in constipation, it would indicate that there is a problem in the muscle activity or that there might be a tear in the muscle. This can help lead to a diagnosis of dyssynergia or an alternative surgical cure.[7]
Defecography studies
In defecography studies, doctors take an X-Ray of the patient and examine their rectum as it empties during defecation. Before the examination, patients are instructed to drink barium an hour before the examination. Barium paste is then inserted into the rectal and anal cavity, and for female patients X-Ray dye is placed on the urinary bladder and in the vagina. The barium is used so that the digestive tract, such as the intestines, rectal cavity, and anal cavity can be seen clearly on the X-Ray and the muscle movements can be examined by doctors.[8]
Digital rectal examinations
During a digital rectal examinations (DRE), a doctor will wear a lubricated latex glove and gently insert one finger, or digit, into the patient’s anus to perform a physical examination of the lower pelvic regions. This test is traditionally used for men to check the prostate gland for any abnormal bumps or growths, and for women to check the uterus and ovaries. This test can help identify complications that may be causing abnormal bowel habits, which can help properly diagnose cases of dyssynergia.[9]
Treatment
Bladder sphincter dyssynergia
Medication
Catheterization
Intermittent
Botox
Urethral stents
Urethral stents are thin wires that are placed within the urethra to either treat or prevent obstruction of urine flowing from the kidney. The stents can either be placed temporarily or permanently.[10]
Sphincterotomy
See also
References
- ^ "Dyssynergia -- Medical Definition". Archived from the original on 2016-04-20. Retrieved 2012-12-08.
- ^ "Ramsay Hunt Syndrome". Archived from the original on 2011-08-28. Retrieved 2011-05-12.
- ^ "National Institute of Neurological Disorders and Stroke". February 14, 2011. Archived from the original on February 16, 2015. Retrieved 2011-05-12.
- PMID 26904418.
- PMID 23577317.
- PMID 20656061. Retrieved March 30, 2016.
- ^ "Patient Information on Anorectal Manometry" (PDF). Motility Society. Archived from the original (PDF) on April 5, 2015. Retrieved March 30, 2016.
- ^ "Defecography". MUSC Health. Medical University of South Carolina. Archived from the original on March 18, 2016. Retrieved March 30, 2016.
- S2CID 23498678.
- ^ PMID 26904418.
- PMID 12494314.