कब्ज क्या है? (Dyssynergic Defecation) - कारण, लक्षण, निदान और इलाज- डॉ सम्राट जानकर #consitpation

GUT FIT CLUB - Kaizen Gastro Care

11 Jul 202314:10

Summary

TLDRDr. Samrat Jankar discusses constipation, a common yet often ignored issue that can lead to serious health problems. He explains the importance of understanding the root cause and the normal defecation process. The video delves into conditions like obstructive defecation syndrome and pelvic floor dysfunction, emphasizing the need for proper diagnosis and treatment. Dr. Jankar highlights the impact on quality of life and the importance of biofeedback therapy as a non-surgical treatment option to improve coordination between the muscles and brain for better bowel movement.

Takeaways

😀 The speaker, Dr. Samrat Jankar, is discussing advanced laparoscopy and colorectal surgery, focusing on a condition often joked about but is actually serious: constipation.
🤔 Constipation is a common issue that many people are embarrassed to discuss, yet it can be the root of various health problems like appendicitis, piles, and cancer.
🔍 Dr. Jankar emphasizes the importance of understanding the root cause of constipation, as it can be a symptom of different medical conditions.
🧠 The normal defecation process is explained, involving signals from the brain to the muscles to coordinate the release of stool.
🚫 Constipation can occur when the muscles do not coordinate properly, leading to incomplete evacuation and the need for frequent trips to the toilet.
🏥 The script describes various diagnostic tests such as digital rectal examination, colonoscopy, and manometric tests to determine the type of constipation.
📊 The importance of a detailed patient history and physical examination is highlighted for accurate diagnosis and treatment planning.
💊 There is a mention of the ineffectiveness of long-term medication for chronic constipation, suggesting that lifestyle changes and therapies are more effective.
🌐 Biofeedback therapy is introduced as a treatment option to improve coordination between the muscles and the brain for better bowel movements.
🔎 The script concludes by encouraging viewers to share the information with friends and family who might be suffering from similar issues and to subscribe to the channel for more health-related content.

Q & A

What is the main issue discussed in the script?
-The main issue discussed in the script is constipation, specifically the condition known as obstructive defecation syndrome, which is a type of pelvic floor dysfunction.
What is the importance of understanding the normal defecation process as mentioned in the script?
-Understanding the normal defecation process is important because it helps in identifying and diagnosing any abnormalities that may be causing constipation or obstructive defecation syndrome.
What is the role of the pelvic floor muscles during normal defecation?
-During normal defecation, the pelvic floor muscles play a crucial role in coordinating the process. They contract to push out stool and relax to allow the stool to pass through.
What is meant by 'biofeedback therapy' in the context of treating constipation?
-Biofeedback therapy is a treatment method that involves teaching patients how to control their pelvic floor muscles to improve bowel movements and alleviate constipation.
What are the potential causes of constipation mentioned in the script?
-Potential causes of constipation mentioned include poor coordination of the pelvic floor muscles, diet, lack of exercise, and certain medications.
How is obstructive defecation syndrome diagnosed?
-Obstructive defecation syndrome is diagnosed through a combination of patient history, physical examination, and tests such as manometry, balloon expulsion test, and defecography.
What is defecography and how does it help in diagnosing constipation?
-Defecography is an imaging test that involves inserting a contrast material into the rectum and taking X-rays to observe the process of defecation. It helps in identifying any structural abnormalities that may be causing constipation.
What is the significance of the balloon expulsion test in evaluating constipation?
-The balloon expulsion test is significant because it assesses the patient's ability to expel a balloon from the rectum, which can indicate issues with the pelvic floor muscles or nerve function.
What is the role of the rectoanal inhibitory reflex in the defecation process?
-The rectoanal inhibitory reflex is a natural reflex that causes the internal anal sphincter to relax when stool enters the rectum, allowing it to pass through. Any issue with this reflex can contribute to constipation.
What lifestyle changes are recommended to manage constipation according to the script?
-Lifestyle changes recommended include improving diet with more fiber, increasing physical activity, and learning to relax and coordinate pelvic floor muscles through biofeedback therapy.
How effective is biofeedback therapy in treating constipation?
-Biofeedback therapy can be effective in treating constipation, especially when it involves teaching patients to properly coordinate their pelvic floor muscles. Improvements can be seen in a significant percentage of patients after a series of sessions.

Outlines

00:00

🚶 Understanding the Seriousness of Constipation

In this paragraph, Dr. Samrat Jankar emphasizes that constipation, often trivialized or overlooked, is a serious health issue. Many people are embarrassed to discuss it, but it can lead to major diseases such as colorectal cancer, appendicitis, and other severe conditions. While medications may provide temporary relief, for a significant number of cases (5-6 out of 10), long-term issues persist, and treatments must address the root cause. One specific condition mentioned is obstructive defecation syndrome (ODS), caused by pelvic floor dysfunction. The video aims to explain the normal defecation process and how ODS disrupts it.

05:00

🧠 The Mechanics of Normal and Disrupted Defecation

Here, Dr. Jankar explains the normal defecation process, where the body coordinates muscle contractions and signals between the brain and the rectum. Any disruption in this coordination, such as when rectal muscles contract but anal muscles fail to relax, can lead to incomplete evacuation and chronic constipation. Patients with disordered defecation may experience prolonged attempts to pass stools, the feeling of incomplete evacuation, or even the need to manually extract stools. This disrupted process is a key characteristic of obstructive defecation syndrome.

10:01

📊 Diagnostic Tools for Obstructive Defecation Syndrome

This section outlines the diagnostic steps used to assess patients with chronic constipation and suspected obstructive defecation syndrome. Dr. Jankar describes how doctors take medical histories, perform physical exams, and use advanced tests such as colonoscopy and anorectal manometry to measure rectal pressure and assess muscle coordination. Techniques like balloon expulsion tests and defecography imaging help to identify structural issues like rectal prolapse or blockages that prevent normal bowel movements.

🧑‍⚕️ Treatment Options: Biofeedback Therapy

In this paragraph, Dr. Jankar discusses available treatments for patients diagnosed with obstructive defecation syndrome, highlighting the effectiveness of biofeedback therapy. This therapy involves training patients to better coordinate their pelvic floor muscles and rectal contractions, with improvements often seen after 6-8 sessions. Biofeedback is non-invasive and has a high success rate, offering an alternative to surgery or long-term medication use. Patients are monitored in real-time, learning to adjust their muscle coordination through visual feedback.

💡 Advanced Options and Final Thoughts

The final paragraph mentions that in rare cases where biofeedback therapy does not work, more advanced treatment options like Botox injections or surgery may be considered, though these are less common. Dr. Jankar concludes by encouraging viewers to share the video and subscribe to the channel if they found the information helpful, stressing the importance of raising awareness about the condition and its treatments.

Mindmap

Keywords

💡Constipation

Constipation refers to difficulty in bowel movements, characterized by infrequent or hard stools. In the video, it is discussed as a common and often ignored issue that can severely impact quality of life. The script mentions that constipation can be a root cause for various other health problems, emphasizing the importance of understanding its causes and addressing it properly.

💡Defecation

Defecation is the process of expelling waste from the body through the rectum and anus. The video script describes the normal defecation process, explaining how it involves a coordinated effort between the muscles of the rectum and anus, and the signals sent from the brain to initiate the process. It's highlighted as a key process that, when not functioning properly, can lead to conditions like constipation.

💡Pelvic Floor

The pelvic floor is a group of muscles that support the pelvic organs. In the context of the video, it is discussed as a critical component in the defecation process. Dysfunction or lack of coordination of the pelvic floor muscles can lead to conditions such as constipation or obstructive defecation syndrome, which is a type of constipation where the muscles do not relax properly during defecation.

💡Obstructive Defecation Syndrome

Obstructive Defecation Syndrome (ODS) is a type of constipation where the muscles of the pelvic floor and rectum do not coordinate properly during defecation, leading to difficulty in passing stool. The script mentions ODS as a subtype of constipation that can be particularly challenging to diagnose and treat, and it is a significant focus of the video's discussion on constipation.

💡Biofeedback Therapy

Biofeedback therapy is a type of treatment that helps patients gain control over bodily functions, such as muscle tension, by providing real-time feedback. In the video, it is presented as a treatment option for constipation and pelvic floor dysfunction. The therapy aims to improve the coordination between the muscles and the brain, which can help alleviate symptoms of conditions like ODS.

💡Digital Rectal Examination

A digital rectal examination is a physical examination performed by a doctor to assess the condition of the rectum and anus. The script mentions this examination as a diagnostic tool to identify issues related to defecation, such as the presence of any masses or the tightness of the anal sphincter muscles.

💡Colonoscopy

Colonoscopy is a procedure that allows doctors to examine the inside of the colon and rectum using a camera attached to a long, flexible tube. It is mentioned in the script as a diagnostic test that can help identify structural issues or diseases of the colon that may contribute to constipation.

💡Manometry

Manometry is a test that measures the pressure within a body cavity or system, such as the rectum. The script describes manometric tests as a way to diagnose defecation disorders by assessing the pressure generated during attempts to expel a balloon from the rectum, which can indicate how well the muscles are coordinating during defecation.

💡Defecography

Defecography, also known as proctography, is an X-ray examination of the rectum and pelvic floor during defecation. The video script mentions this test as a way to visualize the movement of the pelvic floor and the rectum during the act of defecation, helping to identify any structural abnormalities or dysfunctions that may be causing constipation.

💡Quality of Life

Quality of life refers to an individual's overall well-being and satisfaction with their life. The script discusses how chronic constipation and related conditions can significantly impact a person's quality of life, affecting their daily routines and causing discomfort.

💡Treatment

Treatment in the context of the video refers to the various medical interventions and therapies available for managing constipation and related disorders. The script outlines different treatment options, including lifestyle changes, medications, biofeedback therapy, and in some cases, surgery.

Highlights

Doctor Samrat Jankar discusses the seriousness of constipation, often overlooked and considered a taboo topic.

Constipation is a precursor to many diseases, including appendicitis, fistula, and cancer.

Approximately 50-60% of constipation cases are due to a condition called obstructive defecation syndrome.

Understanding the normal defecation process is crucial for identifying issues in constipation.

The process of normal defecation involves coordination between the rectum, anus, and pelvic floor muscles.

In constipation, the muscles do not coordinate properly, leading to incomplete evacuation.

Patients with constipation may experience hard stools, infrequent bowel movements, or a feeling of incomplete evacuation.

Constipation can lead to a decreased quality of life, affecting daily routines and overall well-being.

Chronic constipation often requires long-term management and may not improve with medication.

Diagnostic tests for constipation include physical examination, blood tests, and colonoscopy.

Colonoscopy is a tube test that examines the colon and rectum for structural issues.

Manometric tests help diagnose the type of defecation disorder by measuring pressure in the rectum and anus.

Defecography is a test that uses X-rays to observe the process of defecation.

Education is a key part of treating constipation, teaching patients how to coordinate their muscles for proper defecation.

Biofeedback therapy is a non-surgical treatment option available for constipation.

Biofeedback therapy involves six to eight sessions, with the potential for significant improvement in classical constipation.

For patients who do not respond to biofeedback therapy, options like Botox injections or surgery may be considered.

The video emphasizes the importance of sharing this information with friends and family who may be suffering from constipation.

The video concludes with a reminder to subscribe to the channel for more health-related content.