This fully revised new edition focuses on the clinical, diagnostic, and therapeutic aspects of conditions encountered by the coloproctologist and gastroenterological surgeon, who are faced with an increasing number of precise and specific treatment modalities.

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

Patients with perianal diseases such as dermatitis do not just visit the dermatologist; they are seen by family doctors, internists, pediatricians, general surgeons, gynecologists, and urologists. This book is truly multi-disciplinary, introducing the surgical specialties to medical proctology and related fields. The procedures described allow effective management of both common and less common diseases, including all the secondary problems that may arise. With increasing travel and increasing immunosuppression, parasitic intestinal diseases are now seen in every type of practice. The standard diagnostic procedures described herein reduce costs in therapy. This new reference in proctology and perianal skin disease gives detailed descriptions of clinical features, laboratory diagnosis, and treatment strategies. It will empower a wide variety of physicians to manage these disorders more effectively.

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.

This open access book deals with imaging of the abdomen and pelvis, an area that has seen considerable advances over the past several years, driven by clinical as well as technological developments. The respective chapters, written by internationally respected experts in their fields, focus on imaging diagnosis and interventional therapies in abdominal and pelvic disease; they cover all relevant imaging modalities, including magnetic resonance imaging, computed tomography, and positron emission tomography. As such, the book offers a comprehensive review of the state of the art in imaging of the abdomen and pelvis. It will be of interest to general radiologists, radiology residents, interventional radiologists, and clinicians from other specialties who want to update their knowledge in this area.

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.

- 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