Defecography

File:Defproc.JPG

A defecography image showing the rectum during defecation.

Defecography, also known as defecating proctography, is a diagnostic test used to evaluate the function of the rectum and anus during the process of defecation. This test is particularly useful in assessing patients with constipation, fecal incontinence, or other disorders of the pelvic floor.

Procedure

The procedure involves the use of fluoroscopy to visualize the rectum and anal canal as the patient attempts to evacuate a contrast material that has been introduced into the rectum. The patient is seated on a specially designed commode that allows for imaging during the act of defecation.

Preparation

Prior to the test, the patient may be asked to undergo a bowel preparation to clear the colon. A contrast agent, typically a thick barium paste, is then introduced into the rectum. This agent helps to outline the rectal walls and anal canal on the X-ray images.

Imaging

During the test, a series of X-ray images are taken as the patient attempts to expel the contrast material. These images can reveal abnormalities in the structure and function of the rectum and anal sphincters. The test can identify issues such as rectocele, intussusception, or anismus.

Indications

Defecography is indicated in patients who present with symptoms such as:

• Chronic constipation
• Fecal incontinence
• Incomplete evacuation
• Pelvic floor dysfunction

Interpretation

The images obtained from defecography are analyzed to assess the movement and function of the rectum and anal canal. Abnormal findings may include:

• Rectal prolapse
• Rectocele
• Enterocele
• Anismus

Limitations

While defecography provides valuable information about the mechanics of defecation, it has limitations. It is a static test and may not fully replicate the dynamic process of defecation. Additionally, the use of contrast material and radiation exposure are considerations.

Related pages

• Constipation
• Fecal incontinence
• Pelvic floor dysfunction
• Proctology