Clinical Features and Associations of Descending Perineum Syndrome in 300 Adults with Constipation in Gastroenterology Referral Practice

Wang, Xiao Jing; Vijayvargiya, Priya; Camilleri, Michael

doi:10.1007/s10620-020-06394-0

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…This straining forces the anterior rectal wall to protrude into the anal canal and creates a sensation of incomplete defecation and weakness of the pelvic floor musculature. Other possible causes reported are weakness of the muscles of the pelvic floor caused by either neuropathic degeneration of muscle that accompanies old age ( 3 – 5 ), trauma to the pelvic floor muscles, or to their nerve supply during pregnancy and childbirth or connective tissue disease ( 4 , 6 , 7 ). Abnormal movements and perineal descent have been described in relation to anorectal disorders including constipation and fecal incontinence.…”

Section: Discussionmentioning

confidence: 99%

“…Excessive and repetitive straining is believed to be one of the main causes of perineal descent. Other possible causes are weakness of the pelvic floor muscles caused by either neuropathic degeneration of muscle that accompanies old age, trauma to the pelvic floor muscles or their nerve supply during pregnancy and childbirth, or connective tissue disorders ( 3 – 7 ). Perineal descent is a common condition.…”

Section: Introductionmentioning

confidence: 99%

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Translating Fecobionics Into a Technique That Addresses Clinical Needs for Objective Perineal Descent Measurements

Zhuang

Hung

Chen

et al. 2021

Clin Transl Gastroenterol

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INTRODUCTION: Perineal descent is a phenomenon associated with anorectal dysfunction. It is diagnosed by defecography but subjected to manual measurements on the images/videos and interobserver bias. Fecobionics is a simulated feces for assessing important physiological parameters during defecation. Here, we translate Fecobionics into a new method for estimation of perineal descent based on electronic signals from the embedded inertial measurement units (IMUs). METHODS: A displacement measurement method by a combined zero-velocity update and gravity compensation algorithm from IMUs was developed. The method was verified in a robot model, which mimicked perineal descent motion. RESULTS: The method correlated well with the reference (R2 = 0.9789) and had a deviation from the peak displacement (range 0.25–2.5 cm) of −0.04 ± 0.498 cm. The method was further validated in 5 human experiments with comparison to the benchmark defecography technology (R2 = 0.79). DISCUSSION: The proposed technology is objective, i.e., electronic measurements rather than by fluoroscopy or MRI. The development may impact clinical practice by providing a resource-saving and objective technology for diagnosing perineal descent in the many patients suffering from anorectal disorders. The technology may also be used in colon experiments with Fecobionics and for other gastrointestinal devices containing IMUs such as ingestible capsules like the Smartpill.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Translating Fecobionics Into a Technique That Addresses Clinical Needs for Objective Perineal Descent Measurements

Zhuang

Hung

Chen

et al. 2021

Clin Transl Gastroenterol

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“…Slow colonic transit is reported in in 10%–20% of patient with HD 7 10 22. Rectal evacuatory dysfunction (including both sensory and structural abnormalities23 24) and descending perineum syndrome25 have been described.…”

Section: Gi Symptoms In Patients With Hypermobilitymentioning

confidence: 99%

Gastrointestinal symptoms and nutritional issues in patients with hypermobility disorders: assessment, diagnosis and management

Lam

Amarasinghe

Zárate-López

et al. 2022

Frontline Gastroenterol

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Patients diagnosed with hypermobile Ehlers-Danlos syndrome and hypermobile spectrum disorders are increasingly presenting to secondary and tertiary care centres with gastrointestinal (GI) symptoms and nutritional issues. Due to the absence of specific guidance, these patients are investigated, diagnosed and managed heterogeneously, resulting in a growing concern that they are at increased risk of iatrogenic harm. This review aims to collate the evidence for the causes of GI symptoms, nutritional issues and associated conditions as well as the burden of polypharmacy in this group of patients. We also describe evidence-based strategies for management, with an emphasis on reducing the risk of iatrogenic harm and improving multidisciplinary team care.

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“…Descending perineal syndrome is defined by at least 4-cm caudal movement of the anorectum upon defecation with a failure of rectoanal angle opening, outlet obstruction, and incomplete defecation. 2 Diagnosis currently relies on identifying excessive perineal descent on digital rectal examination (DRE) with confirmation on defecating proctogram. 2 Clinical experience had identified the coexistence of defecatory disorder in patients presenting with chronic diarrhea.…”

mentioning

confidence: 99%

“…2 Diagnosis currently relies on identifying excessive perineal descent on digital rectal examination (DRE) with confirmation on defecating proctogram. 2 Clinical experience had identified the coexistence of defecatory disorder in patients presenting with chronic diarrhea. Diarrheapredominant functional disorders may present with fecal urgency and incontinence, usually because of concomitant weakness of the internal or external anal sphincters or fatigue of the voluntarily controlled external anal sphincter.…”

mentioning

confidence: 99%

Rectal Evacuation Disorders in Patients Presenting With Chronic Functional Diarrhea

Sannaa¹,

BouSaba²,

Magnus

et al. 2022

Gastro Hep Advances

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Clinical Features and Associations of Descending Perineum Syndrome in 300 Adults with Constipation in Gastroenterology Referral Practice

Cited by 10 publications

References 21 publications

Translating Fecobionics Into a Technique That Addresses Clinical Needs for Objective Perineal Descent Measurements

Translating Fecobionics Into a Technique That Addresses Clinical Needs for Objective Perineal Descent Measurements

Gastrointestinal symptoms and nutritional issues in patients with hypermobility disorders: assessment, diagnosis and management

Rectal Evacuation Disorders in Patients Presenting With Chronic Functional Diarrhea

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