Sagar P M, Pemberton J H
Mayo Clinic, Rochester, Minnesota, USA.
Gastroenterol Clin North Am. 1996 Mar;25(1):163-82. doi: 10.1016/s0889-8553(05)70370-8.
Anorectal tests need to be tailored to the presentation of the individual patient. Clearly the tests are most useful when they identify anatomic or physiologic abnormalities for which there are successful treatments. For the incontinent patient, anal manometry is the most useful test. Sphincter injuries should be repaired, whereas neurogenic incontinence is best treated initially with biofeedback. Three tests are more useful for the constipated patient: colonic transit time, degree of pelvic floor descent on straining, and balloon expulsion. Colonic inertia responds to total colectomy and pelvic floor dysfunction to biofeedback. Meanwhile, patients with irritable bowel syndrome require rereferral back to their physicians.
肛肠检查需要根据个体患者的表现进行调整。显然，当这些检查能够识别出有成功治疗方法的解剖学或生理学异常时，它们最为有用。对于大便失禁的患者，肛门测压是最有用的检查。括约肌损伤应予以修复，而神经源性失禁最初最好采用生物反馈治疗。有三项检查对便秘患者更有用：结肠传输时间、用力排便时盆底下降程度以及气囊排出试验。结肠无力对全结肠切除术有反应，盆底功能障碍对生物反馈有反应。同时，肠易激综合征患者需要再次转诊给他们的医生。
