Colorectal or rectonal disease

Question 1

What is the principle function of the colon?

Answer 1

Absorption of water and electrolytes
Fermentation

Question 2

What happens with loss of colon function?

Answer 2

↓ absorption of water and electrolytes
More fluid feces
Changes in motility (↑ giant migrating contractions)
Inflammatory cytokines

Question 3

Internal anal sphincter (smooth muscle)

Answer 3

Parasympathetic: sphincter relax, rectum contract
Sympathetic: Sphincter contract, rectum relax

Question 4

External anal sphincter (skeletal muscle)

Answer 4

Pudendal nerve (sphincter tone)
Muscles of the pelvic diaphragm
Incontinence with damage

Question 5

Dyschezia

Answer 5

Difficult/ painful defecation
May posture but not defecate, cry out with attempts, accompanied by hemtochezia

Question 6

Diseases associated with dyschezia

Answer 6

Pseudoproctasis, perianal fistula, perineal hernia and anal spasm

Question 7

Tenesmus

Answer 7

Ineffectual effort to defecate (nothing in bowel)
Straining due to abnormalities in urination, defecation, parturition
Assoc with constipation/ diarrhea

Question 8

Diseases associated with tenesmus

Answer 8

Colitis, obstruction due to rectal foreign body or tumor

Question 9

Constipation

Answer 9

Infrequent defecation
Excessively hard feces, ↑ straining to defecate, reduced fecal vol

Question 10

Dietary causes of constipation

Answer 10

Bones or excessive hair

Question 11

Anorectal causes of of constipation

Answer 11

Perianal fistulas
Anal stricture or anal sac disease
Ulcerating neoplasia
Anal foreign body

Question 12

Neurogenic causes of constipation

Answer 12

Spinal cord disease or disc disease

Question 13

Iatrogenic causes of constipation

Answer 13

Surgery (of perianal region)
Medication (pain meds)

Question 14

Trauma causing constipation

Answer 14

Fractured pelvis, femur or tibia
Dislocated femur
Bite wounds
Abscess in perineum

Question 15

Extratraluminlal causes of constipation

Answer 15

Healed pelvic fracture
Prostatic hypertrophy
Pelvic tumor
Pseudocoprostasis

Question 16

Intraluminal causes of constipation

Answer 16

Colonic or rectal tumor
Perianal hernia
Foreign body

Question 17

Obstipation

Answer 17

Constipation that hasn’t been treated
Irreversible degenerative changes in intestinal musculature of neurogenic control
Guarded prognosis

Question 18

Obstipation leads to __________

Answer 18

Megacolon (Extreme dilation of the colon)
Primary: idiopathic defect of colonic smooth muscle (cats)
Secondary: Obstruction or defecation for long time

Question 19

Fecal incontinence

Answer 19

Inability to retain feces and defecate normally
Secondary to neurological disease, surgery or neural trauma

Question 20

Diagnostic steps

Answer 20

Signalment, history, complete PE
CBC, serum chem, urinalysis, fecal analysis
Imaging

Question 21

Colorectal/ rectonal age diseases (young)

Answer 21

Congenital anal stenosis
Rectovaginal fistula

Question 22

Colorectal/ rectonal age diseases (old)

Answer 22

Rectal adenoma/ adenocarcinoma
Perianal adenoma/ carcinoma

Question 23

Colorectal/ rectonal cat diseases

Answer 23

Cats: hyperthyroidism, tail pull injury, manx cat syndrome, megacolon

Question 24

Colorectal/ rectonal dog diseases

Answer 24

Anal gland impaction, perianal fistula

Question 25

Colorectal/ rectonal gender and breed diseases

Answer 25

Gender: prostatic disease
Breed: perianal fistula in german shepherds

Question 26

Abdominal palpation

Answer 26

Colonic material
Bladder
Presence/ absence of masses

Question 27

Rectal palpation

Answer 27

Prostate
Pelvis and pelvic urethra
Fecal consistency and contents
Presence of blood, mucus and masses
Ease of performing
Anal sac size and ability to express

Question 28

Perianal region palpation

Answer 28

Observe for masses
Sensitivity

Question 29

Neurological examination

Answer 29

Mental status
Gait
Pelvic limb muscle strength and tone
Withdrawal reflex***
Proprioception
Tail carriage
Anal sphincter tone
Presence of lumbosacral pain