defecation:physio&pathos

1. Kurdistan Board GEH/GIT Surgery J Club 2021
Supervised by Professor Dr. Mohamed Alshekhani.

2. Introduction:
 Defaecation,ubiquitous human experience, requires the coordination of the
anorectum & colon, pelvic floor musculature, eneteric,peripheral&CNS.
 Defaecation is best appreciated through the description of four phases,
which are, temporally&physiologically, reasonably discrete.
 Given its complexity, it is unsurprising that disorders of defaecation are
both common&problematic; almost everyone will experience constipation
at some time in their life&many will develop faecal incontinence.
 A detailed understanding of the normal physiology of defaecation&
continence is critical to inform management of disorders of defaecation.
 During the past decade, there have been major advances in the
investigative tools used to assess colonic&anorectal function.
 This is an overview of anatomy& physiology, a description of the four
phases of defaecation&factors influencing defaecation (demographics,
stool frequency/consistency, psychobehavioural, posture, circadian
rhythm, dietary intake&medications).
 Known pathophysio of defaecation disorders; constipation, incontinence,
IBS&considerations for further research.

3. Introduction:
 Our understanding of the physiology of defaecation& continence (and also
the pathophysiology of conditions such as constipation&faecal
incontinence) has progressed considerably, although fundamental
uncertainties still remain, particularly regarding the actions, interactions
& integration of the myogenic, neural&hormonal mechanisms involved in
colonic/anorectal function.
 It is through resolution of these uncertainties that more effective
assessment& individualized treatment of disorders of defaecation will
hopefully be achieved.
 Narrowing specific gaps in our knowledge will assist in better
understanding.