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.

Anal and Rectal Diseases: A Concise Manual provides a succinct reference on the subject for clinicians, including primary care physicians, gastroenterologists, general surgeons, physician's assistants and nurse practitioners. Presented in a consistent structural style that provides both a general summary of individual topics within the field along with additional details to assist those with some background knowledge in the subject area, this handy volume provides information related to the field of anorectal disease in a format that is easily accessible for rapid acquisition of knowledge. Each topic is outlined in a multidisciplinary fashion with the medical, surgical, and pathological aspects clearly detailed in each section. Each section clearly describes the condition with up-to-date management guidelines and precious clinical pearls. The volume features high quality illustrations in the form of elegant hand drawn figures, tables, photographs of physical findings, endoscopic finds and radiographs. The clinical photographs and x-rays will be of great value to gastroenterologists whose specialty is not coloproctology. Chapters on computerized tomographic colography (virtual colonoscopy) and others cover the newer technologies employed for diagnostic purposes in these diseases. Anal and Rectal Diseases: A Concise Manual provides clinicians with a tool for rapid consultation for direct patient care and management.

This first reference to comprehensively address both the medical and surgical management of diseases affecting the colon, this source spans the wide array of colorectal disorders including rectal prolapse, irritable bowel syndrome, benign and malignant colonic tumors, fissures and ulcers, and Crohn's colitis, among other ailments. With chapters by

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.

This third edition text provides a completely revised and updated new version of this unique, modern, practical text that covers the strategic evaluation, specific approaches, and detailed management techniques utilized by expert colorectal surgeons caring for patients with complex problems–whether they result from underlying colorectal disease or from complications arising from previous surgical therapy. The format follows that of both a “how to” manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. By making use of evidence-based recommendations, each chapter includes not only background information and diagnostic/therapeutic guidelines, but also provides a narrative by the author on his/her operative technical details and perioperative “tips and tricks” that they utilize in the management of these complex surgical challenges. Distinctive to this book, is the reliance on experts in the field including past presidents of the ASCRS, as well as multiple other national and internationally recognized surgeons, to lend their personal insight into situations where data may be more sparse, but individual and collective experience is paramount to making sound decisions and thereby optimizing patient outcomes. The text includes chapters on the assessment of risk and methods utilized to minimize perioperative complications. In addition, it incorporates sections covering the medical and surgical therapies for abdominal, pelvic and anorectal disease. Moreover, the technical challenges of managing complications resulting from the original or subsequent operations is addressed. The underlying focus throughout the text is on providing pragmatic and understandable solutions that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems. However, it also goes beyond the technical aspects of colorectal surgery and includes special sections highlighting the essence of a surgeon; covering aspects involving the medical-legal, ethical, and economic challenges confronting surgeons. Throughout the text, each author provides an ongoing narrative of his/her individual surgical techniques along with illustrations and diagrams to “personally” take the reader through the crucial steps of the procedure, and key points of patient care inherent to that topic. Additionally, where appropriate, links to online videos give the reader an up-front look into technical aspects of colorectal surgery.

The ASCRS Textbook of Surgery of the Colon and Rectum offers a comprehensive textbook designed to provide state of the art information to residents in training and fully trained surgeons seeking recertification. The textbook also supports the mission of the ASCRS to be the world’s authority on colon and rectal disease. The combination of junior and senior authors selected from the membership of the ASCRS for each chapter will provide a comprehensive summary of each topic and allow the touch of experience to focus and temper the material. This approach should provide the reader with a very open minded, evidence based approach to all aspects of colorectal disease. Derived from the textbook, The ASCRS Manual of Surgery of the Colon and Rectum offers a “hands on” version of the textbook, written with the same comprehensive, evidence-based approach but distilled to the clinical essentials. In a handy pocket format, readers will find the bread and butter information for the broad spectrum of practice. In a consistent style, each chapter outlines the condition or procedure being discussed in a concise outline format – easy to read, appropriately illustrated and referenced.