Kahleb Graham

125 timestamped statements across 5 collections — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Colorectal / ARM & Hirschsprung · guest expert Intestinal Rehab · guest expert Motility / Pseudo-obstruction · guest expert

Featured diaries

Ep 93 · 9:19
They no longer have that rectal sigmoid break, and you actually might see contractions going all the way from, uh, the, the, the right side of the colon all the way down to the sphincters.
Ep 41 · 9:19
They no longer have that rectal sigmoid break, and you actually might see contractions going all the way from, uh, the, the, the right side of the colon all the way down to the sphincters.
Ep 42 · 9:19
They no longer have that rectal sigmoid break, and you actually might see contractions going all the way from, uh, the, the, the right side of the colon all the way down to the sphincters.
Ep 42 · 9:19
They no longer have that rectal sigmoid break, and you actually might see contractions going all the way from, uh, the, the, the right side of the colon all the way down to the sphincters.
Ep 3 · 9:19
They no longer have that rectal sigmoid break, and you actually might see contractions going all the way from, uh, the, the, the right side of the colon all the way down to the sphincters.
Ep 93 · 3:02
Is you're supposed to push from your belly, increasing your intraabdominal pressure, and also relaxing your bottom, creating a positive pressure.

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The Colorectal Quiz Episode 8: Motility Disorders Part 1

Ep 91 · 2:51
clinical Failure of medical management is defined as appropriate treatment with no appropriate response
Ep 91 · 2:51
quote That's an excellent question, Mark, because defining failure of medical management is multifolded.
Ep 91 · 3:04
clinical Patients who cannot take treatment (e.g., kids with autism or other cognitive problems) are considered to have failed medical management
Ep 91 · 3:04
clinical Patients with persistent symptoms or pain with treatment, or failure to grow, are considered to have failed medical management
Ep 91 · 3:21
clinical Failure of retrograde enemas is considered failure of medical management
Ep 91 · 5:27
clinical In patients with long-standing constipation where appropriate treatments have been tried and failed, the first step is diagnostic studies including contrast enema to assess colonic dilation, redundancy, and ensure normal ratio

The Colorectal Quiz Episode 9: Motility Disorders Part 2

Ep 93 · 2:24
clinical A Sitz marker study is recommended to assess colonic transit.
Ep 93 · 2:35
clinical Anorectal manometry should assess resting pressure; high resting pressure may indicate a patient amenable to anal Botox.
Ep 93 · 2:49
clinical Conscious rectal sensitivity threshold is tested by gradually inflating a balloon to determine when the patient has a sensation to defecate.
Ep 93 · 2:53
quote Gradually blowing up the balloon and getting a sense when the patient actually has a sensation to go to the bathroom.
Ep 93 · 3:00
clinical Normal defecation physiology involves pushing from the belly (increasing intraabdominal pressure) and relaxing the anal sphincter, creating a positive pressure gradient.
Ep 93 · 3:02
quote Is you're supposed to push from your belly, increasing your intraabdominal pressure, and also relaxing your bottom, creating a positive pressure.
Ep 93 · 3:09
clinical Motility disorder patients may have a negative pressure gradient during defecation, termed dyssynergia, and may benefit from pelvic floor physical therapy or biofeedback.
Ep 93 · 3:39
clinical Sitz marker study is performed by having the patient ingest markers and obtaining an X-ray at day 5.
Ep 93 · 3:48
clinical Sitz marker study is used as a screening test; if markers are scattered throughout the colon or predominantly on the right side, colonic manometry may be indicated.
Ep 93 · 4:13
clinical If all Sitz markers have disappeared on day-5 X-ray, the patient has stooled, even if they report not having done so; the markers do not dissolve.
Ep 93 · 4:22
quote They don't dissolve.
Ep 93 · 8:38
clinical Some patients have a true outlet issue with a normal colon on manometry.
Ep 93 · 8:40
quote There are some patients who they have, they truly have an outlet issue, and their colon is actually normal.
Ep 93 · 8:47
clinical Colonic manometry can characterize whether contractions are well coordinated (neuropathic problem) or low amplitude (myopathic problem).
Ep 93 · 8:57
quote So is there a more of a neuropathic problem, or is there a low amplitude issue and there's Actually a myopathic problem.
Ep 93 · 9:03
clinical Contractions should propagate from the right colon to the rectum; the rectum does not have the same contractions as the colon.
Ep 93 · 9:09
quote Your rectum does not have those same contractions.
Ep 93 · 9:12
clinical In Hirschsprung patients status post pull-through, the rectosigmoid brake is removed, and contractions may be seen extending from the right colon all the way to the sphincters.
Ep 93 · 9:19
quote They no longer have that rectal sigmoid break, and you actually might see contractions going all the way from, uh, the, the, the right side of the colon all the way down to the sphincters.
Constipation 6 entries

The Colorectal Quiz Episode 8: Motility Disorders Part 1

Ep 1 · 2:51
clinical Failure of medical management is defined as appropriate treatment with no appropriate response
Ep 1 · 2:51
quote That's an excellent question, Mark, because defining failure of medical management is multifolded.
Ep 1 · 3:04
clinical Patients with persistent symptoms or pain with treatment, or failure to grow, are considered to have failed medical management
Ep 1 · 3:04
clinical Patients who cannot take treatment (e.g., kids with autism or other cognitive problems) are considered to have failed medical management
Ep 1 · 3:21
clinical Failure of retrograde enemas is considered failure of medical management
Ep 1 · 5:27
clinical In patients with long-standing constipation where appropriate treatments have been tried and failed, the first step is diagnostic studies including contrast enema to assess colonic dilation, redundancy, and ensure normal ratio

The Colorectal Quiz Episode 8: Motility Disorders Part 1

Ep 39 · 2:51
clinical Failure of medical management is defined as appropriate treatment with no appropriate response
Ep 39 · 2:51
quote That's an excellent question, Mark, because defining failure of medical management is multifolded.
Ep 39 · 3:04
clinical Patients who cannot take treatment (e.g., kids with autism or other cognitive problems) are considered to have failed medical management
Ep 39 · 3:04
clinical Patients with persistent symptoms or pain with treatment, or failure to grow, are considered to have failed medical management
Ep 39 · 3:21
clinical Failure of retrograde enemas is considered failure of medical management
Ep 39 · 5:27
clinical In patients with long-standing constipation where appropriate treatments have been tried and failed, the first step is diagnostic studies including contrast enema to assess colonic dilation, redundancy, and ensure normal ratio

The Colorectal Quiz Episode 9: Motility Disorders Part 2

Ep 41 · 2:24
clinical A Sitz marker study is recommended to assess colonic transit.
Ep 41 · 2:35
clinical Anorectal manometry should assess resting pressure; high resting pressure may indicate a patient amenable to anal Botox.
Ep 41 · 2:49
clinical Conscious rectal sensitivity threshold is tested by gradually inflating a balloon to determine when the patient has a sensation to defecate.
Ep 41 · 2:53
quote Gradually blowing up the balloon and getting a sense when the patient actually has a sensation to go to the bathroom.
Ep 41 · 3:00
clinical Normal defecation physiology involves pushing from the belly (increasing intraabdominal pressure) and relaxing the anal sphincter, creating a positive pressure gradient.
Ep 41 · 3:02
quote Is you're supposed to push from your belly, increasing your intraabdominal pressure, and also relaxing your bottom, creating a positive pressure.
Ep 41 · 3:09
clinical Motility disorder patients may have a negative pressure gradient during defecation, termed dyssynergia, and may benefit from pelvic floor physical therapy or biofeedback.
Ep 41 · 3:39
clinical Sitz marker study is performed by having the patient ingest markers and obtaining an X-ray at day 5.
Ep 41 · 3:48
clinical Sitz marker study is used as a screening test; if markers are scattered throughout the colon or predominantly on the right side, colonic manometry may be indicated.
Ep 41 · 4:13
clinical If all Sitz markers have disappeared on day-5 X-ray, the patient has stooled, even if they report not having done so; the markers do not dissolve.
Ep 41 · 4:22
quote They don't dissolve.
Ep 41 · 8:38
clinical Some patients have a true outlet issue with a normal colon on manometry.
Ep 41 · 8:40
quote There are some patients who they have, they truly have an outlet issue, and their colon is actually normal.
Ep 41 · 8:47
clinical Colonic manometry can characterize whether contractions are well coordinated (neuropathic problem) or low amplitude (myopathic problem).
Ep 41 · 8:57
quote So is there a more of a neuropathic problem, or is there a low amplitude issue and there's Actually a myopathic problem.
Ep 41 · 9:03
clinical Contractions should propagate from the right colon to the rectum; the rectum does not have the same contractions as the colon.
Ep 41 · 9:09
quote Your rectum does not have those same contractions.
Ep 41 · 9:12
clinical In Hirschsprung patients status post pull-through, the rectosigmoid brake is removed, and contractions may be seen extending from the right colon all the way to the sphincters.
Ep 41 · 9:19
quote They no longer have that rectal sigmoid break, and you actually might see contractions going all the way from, uh, the, the, the right side of the colon all the way down to the sphincters.
Intestinal Rehab 44 entries

The Colorectal Quiz Episode 8: Motility Disorders Part 1

Ep 41 · 2:51
quote That's an excellent question, Mark, because defining failure of medical management is multifolded.
Ep 41 · 2:51
clinical Failure of medical management is defined as appropriate treatment with no appropriate response
Ep 41 · 3:04
clinical Patients who cannot take treatment (e.g., kids with autism or other cognitive problems) are considered to have failed medical management
Ep 41 · 3:04
clinical Patients with persistent symptoms or pain with treatment, or failure to grow, are considered to have failed medical management
Ep 41 · 3:21
clinical Failure of retrograde enemas is considered failure of medical management
Ep 41 · 5:27
clinical In patients with long-standing constipation where appropriate treatments have been tried and failed, the first step is diagnostic studies including contrast enema to assess colonic dilation, redundancy, and ensure normal ratio

The Colorectal Quiz Episode 9: Motility Disorders Part 2

Ep 42 · 2:24
clinical A Sitz marker study is recommended to assess colonic transit.
Ep 42 · 2:24
clinical A Sitz marker study is recommended to assess colonic transit.
Ep 42 · 2:35
clinical Anorectal manometry should assess resting pressure; high resting pressure may indicate a patient amenable to anal Botox.
Ep 42 · 2:35
clinical Anorectal manometry should assess resting pressure; high resting pressure may indicate a patient amenable to anal Botox.
Ep 42 · 2:49
clinical Conscious rectal sensitivity threshold is tested by gradually inflating a balloon to determine when the patient has a sensation to defecate.
Ep 42 · 2:49
clinical Conscious rectal sensitivity threshold is tested by gradually inflating a balloon to determine when the patient has a sensation to defecate.
Ep 42 · 2:53
quote Gradually blowing up the balloon and getting a sense when the patient actually has a sensation to go to the bathroom.
Ep 42 · 2:53
quote Gradually blowing up the balloon and getting a sense when the patient actually has a sensation to go to the bathroom.
Ep 42 · 3:00
clinical Normal defecation physiology involves pushing from the belly (increasing intraabdominal pressure) and relaxing the anal sphincter, creating a positive pressure gradient.
Ep 42 · 3:00
clinical Normal defecation physiology involves pushing from the belly (increasing intraabdominal pressure) and relaxing the anal sphincter, creating a positive pressure gradient.
Ep 42 · 3:02
quote Is you're supposed to push from your belly, increasing your intraabdominal pressure, and also relaxing your bottom, creating a positive pressure.
Ep 42 · 3:02
quote Is you're supposed to push from your belly, increasing your intraabdominal pressure, and also relaxing your bottom, creating a positive pressure.
Ep 42 · 3:09
clinical Motility disorder patients may have a negative pressure gradient during defecation, termed dyssynergia, and may benefit from pelvic floor physical therapy or biofeedback.
Ep 42 · 3:09
clinical Motility disorder patients may have a negative pressure gradient during defecation, termed dyssynergia, and may benefit from pelvic floor physical therapy or biofeedback.
Ep 42 · 3:39
clinical Sitz marker study is performed by having the patient ingest markers and obtaining an X-ray at day 5.
Ep 42 · 3:39
clinical Sitz marker study is performed by having the patient ingest markers and obtaining an X-ray at day 5.
Ep 42 · 3:48
clinical Sitz marker study is used as a screening test; if markers are scattered throughout the colon or predominantly on the right side, colonic manometry may be indicated.
Ep 42 · 3:48
clinical Sitz marker study is used as a screening test; if markers are scattered throughout the colon or predominantly on the right side, colonic manometry may be indicated.
Ep 42 · 4:13
clinical If all Sitz markers have disappeared on day-5 X-ray, the patient has stooled, even if they report not having done so; the markers do not dissolve.
Ep 42 · 4:13
clinical If all Sitz markers have disappeared on day-5 X-ray, the patient has stooled, even if they report not having done so; the markers do not dissolve.
Ep 42 · 4:22
quote They don't dissolve.
Ep 42 · 4:22
quote They don't dissolve.
Ep 42 · 8:38
clinical Some patients have a true outlet issue with a normal colon on manometry.
Ep 42 · 8:38
clinical Some patients have a true outlet issue with a normal colon on manometry.
Ep 42 · 8:40
quote There are some patients who they have, they truly have an outlet issue, and their colon is actually normal.
Ep 42 · 8:40
quote There are some patients who they have, they truly have an outlet issue, and their colon is actually normal.
Ep 42 · 8:47
clinical Colonic manometry can characterize whether contractions are well coordinated (neuropathic problem) or low amplitude (myopathic problem).
Ep 42 · 8:47
clinical Colonic manometry can characterize whether contractions are well coordinated (neuropathic problem) or low amplitude (myopathic problem).
Ep 42 · 8:57
quote So is there a more of a neuropathic problem, or is there a low amplitude issue and there's Actually a myopathic problem.
Ep 42 · 8:57
quote So is there a more of a neuropathic problem, or is there a low amplitude issue and there's Actually a myopathic problem.
Ep 42 · 9:03
clinical Contractions should propagate from the right colon to the rectum; the rectum does not have the same contractions as the colon.
Ep 42 · 9:03
clinical Contractions should propagate from the right colon to the rectum; the rectum does not have the same contractions as the colon.
Ep 42 · 9:09
quote Your rectum does not have those same contractions.
Ep 42 · 9:09
quote Your rectum does not have those same contractions.
Ep 42 · 9:12
clinical In Hirschsprung patients status post pull-through, the rectosigmoid brake is removed, and contractions may be seen extending from the right colon all the way to the sphincters.
Ep 42 · 9:12
clinical In Hirschsprung patients status post pull-through, the rectosigmoid brake is removed, and contractions may be seen extending from the right colon all the way to the sphincters.
Ep 42 · 9:19
quote They no longer have that rectal sigmoid break, and you actually might see contractions going all the way from, uh, the, the, the right side of the colon all the way down to the sphincters.
Ep 42 · 9:19
quote They no longer have that rectal sigmoid break, and you actually might see contractions going all the way from, uh, the, the, the right side of the colon all the way down to the sphincters.

The Colorectal Quiz Episode 8: Motility Disorders Part 1

Ep 2 · 2:51
clinical Failure of medical management is defined as appropriate treatment with no appropriate response
Ep 2 · 2:51
quote That's an excellent question, Mark, because defining failure of medical management is multifolded.
Ep 2 · 3:04
clinical Patients with persistent symptoms or pain with treatment, or failure to grow, are considered to have failed medical management
Ep 2 · 3:04
clinical Patients who cannot take treatment (e.g., kids with autism or other cognitive problems) are considered to have failed medical management
Ep 2 · 3:21
clinical Failure of retrograde enemas is considered failure of medical management
Ep 2 · 5:27
clinical In patients with long-standing constipation where appropriate treatments have been tried and failed, the first step is diagnostic studies including contrast enema to assess colonic dilation, redundancy, and ensure normal ratio

The Colorectal Quiz Episode 9: Motility Disorders Part 2

Ep 3 · 2:24
clinical A Sitz marker study is recommended to assess colonic transit.
Ep 3 · 2:35
clinical Anorectal manometry should assess resting pressure; high resting pressure may indicate a patient amenable to anal Botox.
Ep 3 · 2:49
clinical Conscious rectal sensitivity threshold is tested by gradually inflating a balloon to determine when the patient has a sensation to defecate.
Ep 3 · 2:53
quote Gradually blowing up the balloon and getting a sense when the patient actually has a sensation to go to the bathroom.
Ep 3 · 3:00
clinical Normal defecation physiology involves pushing from the belly (increasing intraabdominal pressure) and relaxing the anal sphincter, creating a positive pressure gradient.
Ep 3 · 3:02
quote Is you're supposed to push from your belly, increasing your intraabdominal pressure, and also relaxing your bottom, creating a positive pressure.
Ep 3 · 3:09
clinical Motility disorder patients may have a negative pressure gradient during defecation, termed dyssynergia, and may benefit from pelvic floor physical therapy or biofeedback.
Ep 3 · 3:39
clinical Sitz marker study is performed by having the patient ingest markers and obtaining an X-ray at day 5.
Ep 3 · 3:48
clinical Sitz marker study is used as a screening test; if markers are scattered throughout the colon or predominantly on the right side, colonic manometry may be indicated.
Ep 3 · 4:13
clinical If all Sitz markers have disappeared on day-5 X-ray, the patient has stooled, even if they report not having done so; the markers do not dissolve.
Ep 3 · 4:22
quote They don't dissolve.
Ep 3 · 8:38
clinical Some patients have a true outlet issue with a normal colon on manometry.
Ep 3 · 8:40
quote There are some patients who they have, they truly have an outlet issue, and their colon is actually normal.
Ep 3 · 8:47
clinical Colonic manometry can characterize whether contractions are well coordinated (neuropathic problem) or low amplitude (myopathic problem).
Ep 3 · 8:57
quote So is there a more of a neuropathic problem, or is there a low amplitude issue and there's Actually a myopathic problem.
Ep 3 · 9:03
clinical Contractions should propagate from the right colon to the rectum; the rectum does not have the same contractions as the colon.
Ep 3 · 9:09
quote Your rectum does not have those same contractions.
Ep 3 · 9:12
clinical In Hirschsprung patients status post pull-through, the rectosigmoid brake is removed, and contractions may be seen extending from the right colon all the way to the sphincters.
Ep 3 · 9:19
quote They no longer have that rectal sigmoid break, and you actually might see contractions going all the way from, uh, the, the, the right side of the colon all the way down to the sphincters.