High Resolution And High Definition Anorectal Manometry

The book provides a comprehensive overview of high resolution and high definition anorectal manometry (HRAM/HDAM), showing the possible benefits of a wider use of these techniques in clinical practice, as well as their limitations. Although these techniques provide fresh insights into anorectal function and offer a new perspective on the pathophysiologic mechanisms of many defecation disturbances, there is a need to clarify whether their use has beneficial effects on clinical management compared to conventional manometry. There is still a considerable way to go to gain the clinical diffusion of esophageal HRM, which has become the gold standard in studying esophageal motility. Indeed, many gastroenterologists and surgeons are convinced that further studies are necessary in order to be able to recommend HRAM and HDAM over and above conventional anorectal manometry. The first part of the book presents anorectal anatomy and pathophysiology, highlighting the indications and limitations of conventional anorectal manometry. The second part then focuses on the general concepts of high resolution manometry and the difference between conventional anorectal manometry and HRAM/HDAM, including technical aspects and different equipment. The third part explains how to perform, analyze and interpret HRAM and HDAM recordings, and describes the parameters study protocol, normal values and how to formulate a particular diagnosis. Lastly, the fourth part includes a collection of normal and pathological images with a glossary of the most frequently terms. Written by experts in the field of anorectal manometry and defecation disorders, this book is of interest to specialists and residents dealing with these conditions.

The book provides a comprehensive overview of high resolution and high definition anorectal manometry (HRAM/HDAM), showing the possible benefits of a wider use of these techniques in clinical practice, as well as their limitations. Although these techniques provide fresh insights into anorectal function and offer a new perspective on the pathophysiologic mechanisms of many defecation disturbances, there is a need to clarify whether their use has beneficial effects on clinical management compared to conventional manometry. There is still a considerable way to go to gain the clinical diffusion of esophageal HRM, which has become the gold standard in studying esophageal motility. Indeed, many gastroenterologists and surgeons are convinced that further studies are necessary in order to be able to recommend HRAM and HDAM over and above conventional anorectal manometry. The first part of the book presents anorectal anatomy and pathophysiology, highlighting the indications and limitations of conventional anorectal manometry. The second part then focuses on the general concepts of high resolution manometry and the difference between conventional anorectal manometry and HRAM/HDAM, including technical aspects and different equipment. The third part explains how to perform, analyze and interpret HRAM and HDAM recordings, and describes the parameters study protocol, normal values and how to formulate a particular diagnosis. Lastly, the fourth part includes a collection of normal and pathological images with a glossary of the most frequently terms. Written by experts in the field of anorectal manometry and defecation disorders, this book is of interest to specialists and residents dealing with these conditions.

While reflux disease, achalasia, esophageal spasm, gastroparesis and IBS include some of the most common disorders in all disease categories, the understanding of their pathophysiology has remained elusive. The field of clinical gastrointestinal motility has for decades relied on the measurement of intestinal movements for diagnosis and management of these difficult and enigmatic disorders of gut function. Although computers have increased the speed with which we can measure the movements of the gut, the devices to measure this movement have not changed in over 20 years. In the last 2 years, a new technologic breakthrough has taken place in the measurement of intestinal movement. The technology is called high resolution manometry. Rather than the old 4 and 8 channels systems of measuring pressure, high resolution employs 36 closely spaced solid state pressure transducers. By using this technology, the resolution of gut motor activity is incredible. This allows for better ways of viewing motility using color as pressure. This technology makes for beautiful images of gut motility that we have never seen before. We have made diagnoses that would never have been appreciated with the old technology. High resolution manometry is taking over conventional manometry worldwide and represents a dramatic leap in a long time stagnant area.

This atlas provides a concise yet comprehensive overview of high-resolution manometry, impedance and pH monitoring. Through instructive text and over 130 high-yield images, the atlas describes the basic principles of esophageal, antroduodenal and anorectal high-resolution manometry, reviews both normal and pathologic findings on manometry, covers technical aspects of pH monitoring and impedance, and outlines advances in equipment, software, and diagnostic guidelines. Written by experts in the field, Atlas of High-Resolution Manometry, Impedance, and pH Monitoring is a valuable resource for gastroenterologists and other clinicians and practitioners who work or are interested in the GI motility field.

This volume provides a comprehensive and up-to-date theoretical review and practical guide on pediatric gastrointestinal motility and functional disorders. The latest edition includes extensively revised and new chapters to reflect the rapidly growing field of pediatric neurogastroenterology. New topics covered include neurobiology of pain in children, functional oropharyngoesophageal assessment, dysautonomia, and psychotropic drugs. The text also features instructive illustrations, photographs, and tables. Written by world-renown experts in the field, Pediatric Neurogastroenterology: Gastrointestinal Motility and Functional Disorders in Children, Second Edition is a valuable resource for pediatric gastroenterologists, adult gastroenterologists, pediatricians, and all professionals involved in the treatment and management of children with such disorders.

Management of benign anorectal disorders is challenging for the treating surgeons as the patients are highly distressed, the symptoms are always alarming, and surgical intervention may be associated with lifelong disabilities such as loss of sphincter control. Written by highly experienced colorectal surgeons, this book provides detailed notes on optimal management of these disorders including pre- and post-operative management. Chapters cover the entire range of benign disorders such as hemorrhoids, fissure, fistula-in-ano, anorectal injuries, anal incontinence, rectal prolapse, pelvic floor disorders, benign tumors and ulcers, and strictures. Chapters on surgical anatomy and physiology equip the surgeons with the information necessary to understand the complex anatomy and functioning of this region which makes surgery all the more difficult. Benign Anorectal Disorders is an essential reading for colorectal surgeons, general surgeons, fellows-in-training and the post-graduate students.

Clinical and Basic Neurogastroenterology and Motility is a state-of-the-art, lucidly written, generously illustrated, landmark publication that comprehensively addresses the underlying mechanisms and management of common adult and pediatric motility disorders. These problems affect 50% of the population and include conditions such as dysphagia, achalasia, gastroesophageal reflux disease, gastroparesis, irritable bowel syndrome (IBS), gas and bloating, SIBO, constipation and fecal incontinence. The book brings together international experts and clinician scientists, epitomizing their years of wisdom into a concise yet practical text that is delivered in two distinct sections, basic and clinical. It fulfills a large unmet need, and bridges a long-awaited knowledge gap among trainees, clinicians, scientists, nurses and technicians, earnestly engaged in this field. First of its kind text that covers both basic and clinical aspects, bridging the knowledge gap, and providing a bench to bedside approach for management of common disorders Discusses the latest concepts and basic principles of neurogastroenterology and motility, and how the gut and brain interact in the genesis of functional gastrointestinal and motility disorders Provides an illustrated and practical text on hot topics written by leading adult and pediatric gastroenterology experts across the globe Includes an accompanying more detailed web version of the text with free access to future podcasts

This excellent textbook provides up-to-date information on all aspects of pelvic floor disorders. After an opening section on anatomy and physiology, it explains the methodology, role and application of the integrated imaging approach in detail, including the most advanced 3D, 4D, and dynamic ultrasound techniques, illustrated with hundreds of images. It then discusses in depth the epidemiology, etiology, assessment, and management of the full range of pelvic floor disorders from multidisciplinary and practical perspectives. The book also provides information on the various forms of obstetric perineal trauma, urinary incontinence and voiding dysfunction, anal incontinence, pelvic organ prolapse, constipation and obstructed defecation, pelvic pain and sexual dysfunction, and fistulas, and includes treatment algorithms as well as helpful guidance on what to do when surgical treatment goes wrong. The authors are leading experts in the field from around the globe. Since the first edition from 2010 (more than 200,000 chapter downloads), the book has been extensively rewritten and features numerous additional topics. The result is a comprehensive textbook that is invaluable for gynecologists, colorectal surgeons, urologists, radiologists, and gastroenterologists, beginners and veterans alike.