General pediatricians typically prescribe osmotic laxatives (MiraLax, lactulose) and stimulant laxatives (Senna, bisacodyl), but there are other medications GI specialists use that pediatricians are not accustomed to prescribing
Anorectal manometry provides information about defecation dynamics by having patients bear down, squeeze, and attempt to defecate, comparing sensation to defecate with internal anal sphincter response
The Colorectal Quiz Episode 8: Motility Disorders Part 1
▶Ep 91 · 3:35
clinicalReliance on rectal therapy or retrograde enemas with continued soiling causing significant effect on functioning is considered failure of medical management↗
▶Ep 91 · 3:57
clinicalGeneral pediatricians typically prescribe osmotic laxatives (MiraLax, lactulose) and stimulant laxatives (Senna, bisacodyl), but there are other medications GI specialists use that pediatricians are not accustomed to prescribing↗
▶Ep 91 · 4:46
clinicalInitial evaluation includes history (triggers, stooling frequency, sensation of complete emptying), physical exam (abdominal distension, palpable stool, rectal exam), and diagnostic imaging (abdominal X-ray, water-soluble contrast enema)↗
▶Ep 91 · 4:58
clinicalSome children stool every day but don't completely evacuate↗
▶Ep 91 · 9:35
clinicalAnorectal manometry uses a catheter with sensors measuring pressure and a balloon to assess anal sphincter function and its relationship to the rectum↗
▶Ep 91 · 10:00
clinicalHigh pressures on anorectal manometry may suggest underlying inability to relax, causing a functional obstruction↗
▶Ep 91 · 10:09
clinicalPatients with Hirschsprung disease have an absent rectoanal inhibitory reflex (RAIR)↗
▶Ep 91 · 10:19
clinicalAnorectal manometry provides information about defecation dynamics by having patients bear down, squeeze, and attempt to defecate, comparing sensation to defecate with internal anal sphincter response↗
The Colorectal Quiz Episode 9: Motility Disorders Part 2
▶Ep 93 · 1:45
clinicalColonic transit and colonic function must be assessed in this patient; it is not purely a sphincter issue.↗
▶Ep 93 · 2:04
clinicalThe massively dilated colon is a result of colonic dysfunction, with dilatation predominantly in the rectosigmoid.↗
▶Ep 93 · 2:15
quoteWe really have to assess the colonic function and provide some sort of mechanical modes of remedy for this.↗
▶Ep 93 · 4:51
clinicalSitz markers can be used as a colonic transit study by obtaining X-rays at days 0, 1, 2, and 4 to visualize marker transit through the colon.↗
▶Ep 93 · 7:07
clinicalColonic manometry provides information on peristaltic activity, specifically the motion of the colon.↗
▶Ep 93 · 7:07
quoteThe colonic manometry, I think, is additionally giving us information on the peristaltic activity, which is basically the motion of the colon.↗
▶Ep 93 · 7:21
clinicalNormal colonic physiology includes two strong contractions per day, called high-amplitude propagating contractions (HAPCs).↗
▶Ep 93 · 7:29
quoteThose are called high amplitude propagating contractions.↗
▶Ep 93 · 7:32
clinicalHAPCs start in the cecum and progress distally in a coordinated manner.↗
▶Ep 93 · 7:37
quoteThen we are able to see these contractions starting on the right side of the colon in the cecum area, and then going proximately in a progressive way.↗
▶Ep 93 · 7:45
clinicalPresence of two HAPCs during an 18- or 24-hour colonic manometry study rules out colonic dysmotility.↗
▶Ep 93 · 7:52
quotePresence of HAPC will essentially rule out colonic slowness or problems, and that's not uncommon.↗
▶Ep 93 · 9:36
clinicalEven if HAPCs are present and colonic motility appears normal, absence of response to stimulants on manometry indicates abnormal colonic motility.↗
▶Ep 93 · 9:45
quoteIf you do not see a response to stimulants, then by definition that patient does not have a normal colonic manometry or. Normal colonic motility.↗
▶Ep 93 · 12:17
quoteWhat we learn from each other is beyond what textbooks can teach us. I think a collaborative model like this should be promoted in every center where we provide care for colorectal cases.↗
The Colorectal Quiz Episode 8: Motility Disorders Part 1
▶Ep 7 · 3:35
clinicalReliance on rectal therapy or retrograde enemas with continued soiling causing significant effect on functioning is considered failure of medical management↗
▶Ep 7 · 3:57
clinicalGeneral pediatricians typically prescribe osmotic laxatives (MiraLax, lactulose) and stimulant laxatives (Senna, bisacodyl), but there are other medications GI specialists use that pediatricians are not accustomed to prescribing↗
▶Ep 7 · 4:46
clinicalInitial evaluation includes history (triggers, stooling frequency, sensation of complete emptying), physical exam (abdominal distension, palpable stool, rectal exam), and diagnostic imaging (abdominal X-ray, water-soluble contrast enema)↗
▶Ep 7 · 4:58
clinicalSome children stool every day but don't completely evacuate↗
▶Ep 7 · 9:35
clinicalAnorectal manometry uses a catheter with sensors measuring pressure and a balloon to assess anal sphincter function and its relationship to the rectum↗
▶Ep 7 · 10:00
clinicalHigh pressures on anorectal manometry may suggest underlying inability to relax, causing a functional obstruction↗
▶Ep 7 · 10:09
clinicalPatients with Hirschsprung disease have an absent rectoanal inhibitory reflex (RAIR)↗
▶Ep 7 · 10:19
clinicalAnorectal manometry provides information about defecation dynamics by having patients bear down, squeeze, and attempt to defecate, comparing sensation to defecate with internal anal sphincter response↗
Anil's statements about Hirschsprung disease23 statements
The Colorectal Quiz Episode 8: Motility Disorders Part 1
▶Ep 39 · 3:35
clinicalReliance on rectal therapy or retrograde enemas with continued soiling causing significant effect on functioning is considered failure of medical management↗
▶Ep 39 · 3:57
clinicalGeneral pediatricians typically prescribe osmotic laxatives (MiraLax, lactulose) and stimulant laxatives (Senna, bisacodyl), but there are other medications GI specialists use that pediatricians are not accustomed to prescribing↗
▶Ep 39 · 4:46
clinicalInitial evaluation includes history (triggers, stooling frequency, sensation of complete emptying), physical exam (abdominal distension, palpable stool, rectal exam), and diagnostic imaging (abdominal X-ray, water-soluble contrast enema)↗
▶Ep 39 · 4:58
clinicalSome children stool every day but don't completely evacuate↗
▶Ep 39 · 9:35
clinicalAnorectal manometry uses a catheter with sensors measuring pressure and a balloon to assess anal sphincter function and its relationship to the rectum↗
▶Ep 39 · 10:00
clinicalHigh pressures on anorectal manometry may suggest underlying inability to relax, causing a functional obstruction↗
▶Ep 39 · 10:09
clinicalPatients with Hirschsprung disease have an absent rectoanal inhibitory reflex (RAIR)↗
▶Ep 39 · 10:19
clinicalAnorectal manometry provides information about defecation dynamics by having patients bear down, squeeze, and attempt to defecate, comparing sensation to defecate with internal anal sphincter response↗
The Colorectal Quiz Episode 9: Motility Disorders Part 2
▶Ep 41 · 1:45
clinicalColonic transit and colonic function must be assessed in this patient; it is not purely a sphincter issue.↗
▶Ep 41 · 2:04
clinicalThe massively dilated colon is a result of colonic dysfunction, with dilatation predominantly in the rectosigmoid.↗
▶Ep 41 · 2:15
quoteWe really have to assess the colonic function and provide some sort of mechanical modes of remedy for this.↗
▶Ep 41 · 4:51
clinicalSitz markers can be used as a colonic transit study by obtaining X-rays at days 0, 1, 2, and 4 to visualize marker transit through the colon.↗
▶Ep 41 · 7:07
clinicalColonic manometry provides information on peristaltic activity, specifically the motion of the colon.↗
▶Ep 41 · 7:07
quoteThe colonic manometry, I think, is additionally giving us information on the peristaltic activity, which is basically the motion of the colon.↗
▶Ep 41 · 7:21
clinicalNormal colonic physiology includes two strong contractions per day, called high-amplitude propagating contractions (HAPCs).↗
▶Ep 41 · 7:29
quoteThose are called high amplitude propagating contractions.↗
▶Ep 41 · 7:32
clinicalHAPCs start in the cecum and progress distally in a coordinated manner.↗
▶Ep 41 · 7:37
quoteThen we are able to see these contractions starting on the right side of the colon in the cecum area, and then going proximately in a progressive way.↗
▶Ep 41 · 7:45
clinicalPresence of two HAPCs during an 18- or 24-hour colonic manometry study rules out colonic dysmotility.↗
▶Ep 41 · 7:52
quotePresence of HAPC will essentially rule out colonic slowness or problems, and that's not uncommon.↗
▶Ep 41 · 9:36
clinicalEven if HAPCs are present and colonic motility appears normal, absence of response to stimulants on manometry indicates abnormal colonic motility.↗
▶Ep 41 · 9:45
quoteIf you do not see a response to stimulants, then by definition that patient does not have a normal colonic manometry or. Normal colonic motility.↗
▶Ep 41 · 12:17
quoteWhat we learn from each other is beyond what textbooks can teach us. I think a collaborative model like this should be promoted in every center where we provide care for colorectal cases.↗
Anil's statements about Intestinal Rehab23 statements
The Colorectal Quiz Episode 8: Motility Disorders Part 1
▶Ep 41 · 3:35
clinicalReliance on rectal therapy or retrograde enemas with continued soiling causing significant effect on functioning is considered failure of medical management↗
▶Ep 41 · 3:57
clinicalGeneral pediatricians typically prescribe osmotic laxatives (MiraLax, lactulose) and stimulant laxatives (Senna, bisacodyl), but there are other medications GI specialists use that pediatricians are not accustomed to prescribing↗
▶Ep 41 · 4:46
clinicalInitial evaluation includes history (triggers, stooling frequency, sensation of complete emptying), physical exam (abdominal distension, palpable stool, rectal exam), and diagnostic imaging (abdominal X-ray, water-soluble contrast enema)↗
▶Ep 41 · 4:58
clinicalSome children stool every day but don't completely evacuate↗
▶Ep 41 · 9:35
clinicalAnorectal manometry uses a catheter with sensors measuring pressure and a balloon to assess anal sphincter function and its relationship to the rectum↗
▶Ep 41 · 10:00
clinicalHigh pressures on anorectal manometry may suggest underlying inability to relax, causing a functional obstruction↗
▶Ep 41 · 10:09
clinicalPatients with Hirschsprung disease have an absent rectoanal inhibitory reflex (RAIR)↗
▶Ep 41 · 10:19
clinicalAnorectal manometry provides information about defecation dynamics by having patients bear down, squeeze, and attempt to defecate, comparing sensation to defecate with internal anal sphincter response↗
The Colorectal Quiz Episode 9: Motility Disorders Part 2
▶Ep 41 · 1:45
clinicalColonic transit and colonic function must be assessed in this patient; it is not purely a sphincter issue.↗
▶Ep 41 · 2:04
clinicalThe massively dilated colon is a result of colonic dysfunction, with dilatation predominantly in the rectosigmoid.↗
▶Ep 41 · 2:15
quoteWe really have to assess the colonic function and provide some sort of mechanical modes of remedy for this.↗
▶Ep 41 · 4:51
clinicalSitz markers can be used as a colonic transit study by obtaining X-rays at days 0, 1, 2, and 4 to visualize marker transit through the colon.↗
▶Ep 41 · 7:07
quoteThe colonic manometry, I think, is additionally giving us information on the peristaltic activity, which is basically the motion of the colon.↗
▶Ep 41 · 7:07
clinicalColonic manometry provides information on peristaltic activity, specifically the motion of the colon.↗
▶Ep 41 · 7:21
clinicalNormal colonic physiology includes two strong contractions per day, called high-amplitude propagating contractions (HAPCs).↗
▶Ep 41 · 7:29
quoteThose are called high amplitude propagating contractions.↗
▶Ep 41 · 7:32
clinicalHAPCs start in the cecum and progress distally in a coordinated manner.↗
▶Ep 41 · 7:37
quoteThen we are able to see these contractions starting on the right side of the colon in the cecum area, and then going proximately in a progressive way.↗
▶Ep 41 · 7:45
clinicalPresence of two HAPCs during an 18- or 24-hour colonic manometry study rules out colonic dysmotility.↗
▶Ep 41 · 7:52
quotePresence of HAPC will essentially rule out colonic slowness or problems, and that's not uncommon.↗
▶Ep 41 · 9:36
clinicalEven if HAPCs are present and colonic motility appears normal, absence of response to stimulants on manometry indicates abnormal colonic motility.↗
▶Ep 41 · 9:45
quoteIf you do not see a response to stimulants, then by definition that patient does not have a normal colonic manometry or. Normal colonic motility.↗
▶Ep 41 · 12:17
quoteWhat we learn from each other is beyond what textbooks can teach us. I think a collaborative model like this should be promoted in every center where we provide care for colorectal cases.↗
Anil's statements about Motility / Pseudo-obstruction23 statements
The Colorectal Quiz Episode 8: Motility Disorders Part 1
▶Ep 2 · 3:35
clinicalReliance on rectal therapy or retrograde enemas with continued soiling causing significant effect on functioning is considered failure of medical management↗
▶Ep 2 · 3:57
clinicalGeneral pediatricians typically prescribe osmotic laxatives (MiraLax, lactulose) and stimulant laxatives (Senna, bisacodyl), but there are other medications GI specialists use that pediatricians are not accustomed to prescribing↗
▶Ep 2 · 4:46
clinicalInitial evaluation includes history (triggers, stooling frequency, sensation of complete emptying), physical exam (abdominal distension, palpable stool, rectal exam), and diagnostic imaging (abdominal X-ray, water-soluble contrast enema)↗
▶Ep 2 · 4:58
clinicalSome children stool every day but don't completely evacuate↗
▶Ep 2 · 9:35
clinicalAnorectal manometry uses a catheter with sensors measuring pressure and a balloon to assess anal sphincter function and its relationship to the rectum↗
▶Ep 2 · 10:00
clinicalHigh pressures on anorectal manometry may suggest underlying inability to relax, causing a functional obstruction↗
▶Ep 2 · 10:09
clinicalPatients with Hirschsprung disease have an absent rectoanal inhibitory reflex (RAIR)↗
▶Ep 2 · 10:19
clinicalAnorectal manometry provides information about defecation dynamics by having patients bear down, squeeze, and attempt to defecate, comparing sensation to defecate with internal anal sphincter response↗
The Colorectal Quiz Episode 9: Motility Disorders Part 2
▶Ep 3 · 1:45
clinicalColonic transit and colonic function must be assessed in this patient; it is not purely a sphincter issue.↗
▶Ep 3 · 2:04
clinicalThe massively dilated colon is a result of colonic dysfunction, with dilatation predominantly in the rectosigmoid.↗
▶Ep 3 · 2:15
quoteWe really have to assess the colonic function and provide some sort of mechanical modes of remedy for this.↗
▶Ep 3 · 4:51
clinicalSitz markers can be used as a colonic transit study by obtaining X-rays at days 0, 1, 2, and 4 to visualize marker transit through the colon.↗
▶Ep 3 · 7:07
quoteThe colonic manometry, I think, is additionally giving us information on the peristaltic activity, which is basically the motion of the colon.↗
▶Ep 3 · 7:07
clinicalColonic manometry provides information on peristaltic activity, specifically the motion of the colon.↗
▶Ep 3 · 7:21
clinicalNormal colonic physiology includes two strong contractions per day, called high-amplitude propagating contractions (HAPCs).↗
▶Ep 3 · 7:29
quoteThose are called high amplitude propagating contractions.↗
▶Ep 3 · 7:32
clinicalHAPCs start in the cecum and progress distally in a coordinated manner.↗
▶Ep 3 · 7:37
quoteThen we are able to see these contractions starting on the right side of the colon in the cecum area, and then going proximately in a progressive way.↗
▶Ep 3 · 7:45
clinicalPresence of two HAPCs during an 18- or 24-hour colonic manometry study rules out colonic dysmotility.↗
▶Ep 3 · 7:52
quotePresence of HAPC will essentially rule out colonic slowness or problems, and that's not uncommon.↗
▶Ep 3 · 9:36
clinicalEven if HAPCs are present and colonic motility appears normal, absence of response to stimulants on manometry indicates abnormal colonic motility.↗
▶Ep 3 · 9:45
quoteIf you do not see a response to stimulants, then by definition that patient does not have a normal colonic manometry or. Normal colonic motility.↗
▶Ep 3 · 12:17
quoteWhat we learn from each other is beyond what textbooks can teach us. I think a collaborative model like this should be promoted in every center where we provide care for colorectal cases.↗
