Colorectal Physiology reviews recent findings in fecal incontinence, which is becoming a greater concern to physicians and surgeons as our population grows older and becomes better educated. International experts in anorectal physiology and management of incontinence present their personal views and specific clinical experiences on topics such as causes, diagnostic testing, and modes of treatment. The contributors also examine theoretical and practical aspects of current opinion. This book is a useful reference for researchers, colon and rectal surgeons, physicians, and students interested in understanding and managing fecal incontinence.

This is the first comprehensive book exclusively dedicated to anorectal physiology and the importance of diagnostic tools in guiding the evaluation and treatment of anorectal dysfunction. Functional disorders, and specifically fecal incontinence and evacuatory disorders, are prevalent in the general population, affecting up to 20% of individuals. As many of these conditions have extremely complex mechanisms, a thorough understanding of anorectal physiology is a crucial element in the surgeon’s “arsenal" to ensure accurate evaluation and to inform treatment. At this time, there is no other title that specifically addresses all aspects of anorectal physiology, as well as anorectal and pelvic floor disorders, including fecal incontinence and defecation disorders. Specifically, the book provides detailed descriptions of diagnostic methods and treatment algorithms for a range of anorectal conditions, including modern treatment modalities such as sacral neuromodulation. A unique and comprehensive reference covering all aspects of the evaluation and treatment of anorectal disorders, Anorectal Physiology – A Clinical and Surgical Perspective will be of significant interest to proctologists and coloproctologists, gastroenterologists, colorectal surgeons, gynecologists and all other professionals interested in anorectal physiology.

- This text gives a more universal approach to the subject - Reaches a wide range of physicians from different disciplines - Easily structured for hands-on diagnosis

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 superbly illustrated book on the surgical treatment of pediatric colorectal problems focuses in particular on the specific technical maneuvers that may be considered key to successful results. The presented management concepts are based on a database comprising over 5000 patients, more than 2300 of whom have been operated on by one of the authors as lead surgeon over the past 30 years. The full range of colorectal disorders in children is thus covered, from cloaca and fistulas to rare presentations. In addition, chapters are included on topics such as prenatal diagnosis, minimally invasive techniques, recent advances in imaging, and a bowel management program for fecal incontinence. Surgical Treatment of Colorectal Problems in Children is eminently a practical book. Clarity, simplicity and applicability are emphasized throughout. The excellence of the illustrations and photographs is a crucial feature and the reader will also have access to instructive videos of procedures.

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.

This is the first volume in the new Springer Major Reference Work series entitled Coloproctology. The book covers key topics in the anatomy and physiology of the colon, rectum and anus and the diagnosis of colorectal/anal diseases and disorders. It thus forms a sound basis for further volumes in the series that will focus on the treatment of more specific clinical conditions. The subjects addressed in the volume are crucial to effective patient management and the book highlights the fact that adequate diagnostic assessment of a given disease is significantly related to the pathophysiologic interpretation of the pathologic process. The purpose of the volume is to provide readers with up-to-date knowledge on colorectal and anal anatomy and physiology, particularly from a treatment perspective and to describe the methodology to be employed in choosing the best diagnostic work-up in coloproctology.

First published in 1994: Colorectal Physiology reviews recent findings in fecal incontinence, which is becoming a greater concern to physicians and surgeons as our population grows older and becomes better educated. International experts in anorectal physiology and management of incontinence present their personal views and specific clinical experiences on topics such as causes, diagnostic testing, and modes of treatment. The contributors also examine theoretical and practical aspects of current opinion. This book is a useful reference for researchers, colon and rectal surgeons, physicians, and students interested in understanding and managing fecal incontinence.

Colorectal Cancer Screening provides a complete overview of colorectal cancer screening, from epidemiology and molecular abnormalities, to the latest screening techniques such as stool DNA and FIT, Computerized Tomography (CT) Colonography, High Definition Colonoscopes and Narrow Band Imaging. As the text is devoted entirely to CRC screening, it features many facts, principles, guidelines and figures related to screening in an easy access format. This volume provides a complete guide to colorectal cancer screening which will be informative to the subspecialist as well as the primary care practitioner. It represents the only text that provides this up to date information about a subject that is continually changing. For the primary practitioner, information on the guidelines for screening as well as increasing patient participation is presentedd. For the subspecialist, information regarding the latest imaging techniques as well as flat adenomas and chromoendoscopy are covered. The section on the molecular changes in CRC will appeal to both groups. The text includes up to date information about colorectal screening that encompasses the entire spectrum of the topic and features photographs of polyps as well as diagrams of the morphology of polyps as well as photographs of CT colonography images. Algorithms are presented for all the suggested guidelines. Chapters are devoted to patient participation in screening and risk factors as well as new imaging technology. This useful volume explains the rationale behind screening for CRC. In addition, it covers the different screening options as well as the performance characteristics, when available in the literature, for each test. This volume will be used by the sub specialists who perform screening tests as well as primary care practitioners who refer patients to be screened for colorectal cancer.

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