# defaecography



## 17176 (Mar 31, 2005)

I have been reading about this method.apparantly is similar to a barium meal and the test is done while you are sitting up.They inject a small amount of barium into the rectum and you do not have to empty the bowel before the procedure takes place..Have you heard of this test eric? i had not until i read the book.This book is well written and explains a lot of things i didnt know, but now do, i would highly reccomend it to other ibs'ers...


----------



## SpAsMaN* (May 11, 2002)

Are you sure you don't have to empty the bowel?


----------



## eric (Jul 8, 1999)

FYI"Defaecography, also named evacuation proctography and videoproctography, a functional radiographic examination of voluntary rectal evacuation. After bowel preparation, the rectum is filled with at least 120 ml of thick barium paste (e.g. oesophagus cream), injected from a large syringe through a catheter introduced into the rectum. The patient is then placed sitting sideways on a special commode placed on the foot rest of the examination table with the table in an upright position. The fluoroscopic examination is video recorded with the patient at rest, during contraction, straining and active evacuation. " As IBSers we certainly go through the ringer on tests and diginity.


----------



## SpAsMaN* (May 11, 2002)

If they don't see the sigmoid,i don't see the purpose of it in my case.Does they see the sigmoid???I have to know,i have one scheduled.


----------



## eric (Jul 8, 1999)

The purpose in your case might be to detect any pelvic floor dysfunction issues. Including the sensation of incomplete evacuation issues.


----------



## SpAsMaN* (May 11, 2002)

HOWEVER,my incomplete evec is NOT in the rectum.It's in the Sigmoid colon.







The sigmoid is NOT involved in the pelvic floor i think.


----------



## 17176 (Mar 31, 2005)

yo spas







im only quoting what it says in the book, which i have engrossed in..


----------



## Screamer (Aug 16, 2005)

Hmmmm sounds charming. Kinda glad I never had to do that one! (Pooping in front of someone is one of my worst nightmares!).


----------



## SpAsMaN* (May 11, 2002)

LOL







I WONDER if it could be a turn off vs blond


----------



## 17176 (Mar 31, 2005)

ah hell im not a prude, the doc ive seen over they years have seen my bum more times than J..


----------



## Screamer (Aug 16, 2005)

Happy to flash my bum if need be (heck, did it in front of DH's work collegues for my colonoscopy) but I draw the line at taking a poop!







(just for those interested, I am very much a prude, I have yet to fluff in front of DH and I've known him for almost 9 years!)


----------



## SpAsMaN* (May 11, 2002)

LETS ROCKS!!!


----------



## Screamer (Aug 16, 2005)

He he


----------



## SpAsMaN* (May 11, 2002)

ENjoy while it last:


----------



## 17176 (Mar 31, 2005)

no flies on me spas, i dont like farting in fron ot anyone, not ladylike.A scottish expression "let your wind blow free, wherever you may be"


----------



## 23677 (Apr 29, 2005)

9 Years???? Come off it Screamer, you must have sneaked a few out during that time?




























If not it might be part of your problem. We are designed to fart you know! Its just that the Queen has someone to apologise for her if she drops one in public.







I know its sometimes risky when you have D but retaining gas for any length of time can add to the stress that the bowel is already under. Also if you happen to have leaky gut syndrome these gases are more likely to be absorbed into your blood stream.Give him a peg for his nose, a couple of ear plugs then zoooom round the room like a venting balloon !!!!!!


----------



## Screamer (Aug 16, 2005)

LOL! I do let it go it's just that I'll get up and run away into the great outdoors or the loo if it's free. He thinks I'm quite funny cause we'll be lying in bed watching a movie and I'll just up and run off for a second and then be back







Okay I confess I let a little toot go just once but it was his fault cause he was tickling me. He keeps telling me I should just let rip, but there's something unladylike about that! Guess I'm just old fashioned when it comes to all things toilet! Not that you'd know it on here but here is the only place I discuss it all (maybe cause I'm somewhat anonymous







)I have at times caused myself great pain holding things in though


----------



## SpAsMaN* (May 11, 2002)

Don't hold it,it is the evil.


----------



## 20250 (Jul 14, 2005)

Jools, This test sounds a little intimidating. The new doc I have does have this test in his repatoure(spelling), Hope he does'nt order this one. Paste,catheter,injection. Ouch!!


----------



## 17176 (Mar 31, 2005)

yep i agree brett and it does sound a wee bit painful, mind you any females on here will agree if you have been in child labour, you can withstand most things.


----------



## Arnie W (Oct 22, 2003)

http://ibsgroup.org/eve/forums/a/tpc/f/431...01271#537101271Jools, you might have missed the above recent thread. ClareM says that it is called a proctogram in the UK. I took note of the thread at the time as I thought it could be applicable for me.


----------



## 17176 (Mar 31, 2005)

thanks arnie, much appreciated


----------



## 20378 (Nov 3, 2005)

I find these postings facinating. I work in health care, I am not a doctor, but have done and will soon be starting up again defecograms (proctography, defecography, etc-mostly all the same) once our department has all the necessary equipment. From a health care viewpoint, yes, defecography is a invasion of your personal privacy (a tube is inserted into the rectum and a barium mixture injected therethrough; it's not an exam most people are excited to hear about). But I can give you some pointers regarding this exam. First off, it sounds like a strange exam, but the diagnostic benefits are incredible. It is a very serious exam and one should prepare themselves physically as well as emotionally and mentally (some people just can't take a dump in front of others). It's important to get over this... try. The barium is pushed through a tube into your rectum (injected sounds like it hurts). It's important that you relax and let it flow in... you will feel full, like you need to make a bm, just relax and hold onto the tube in your rectum (the tube typically has a ballon to help retain it's place, but it is important for the patient to try not to let it shoot out accidentally-it does happen). Breath deep and relax, it's a very simple procedure and will be over before you know it. The people doing it will try to maintain your privacy to the highest extent possible, but you do need to be aware of the need for certain exposure (ie to place the tube into the rectum and put the barium in the vagina for women-a practice done in some departments). You will be filled with not much barium, but it may feel like a lot, don't worry, barium will not cause any damage and will be defecated very soon. Now we come to the videotaping of the exam. Generally still x-rays are taken during the exam to show prolapses and rectoceles among other conditions, as well as a video tape to review the entire exam is very useful. No one there is doing the exam because they love doing it. Quite simply we're here for you, we understand, we've been there before (most everyone I know that works as a nurse or technician has personally gone through what you're going through and that is why they are in the field that they are in...That is why *I* do what I do). This exam is there to help you be diagnosed in order to get the proper treatment to correct the problem; among the many baruim studies (ie barium enemas, Small bowel follow throughs SBFT, Upper GI Studies) this is an extremely effective and useful exam for rectal problems. Hope it goes well.-Jon


----------



## 17176 (Mar 31, 2005)

hello and welcome to the board jon.


----------



## 23677 (Apr 29, 2005)

Good onya Jon! Stick with us, mate!


----------



## Arnie W (Oct 22, 2003)

Thankyou so much for that. Anyone with digestive disorders is likely to have to go through some invasive procedure at one stage or another. We just have to grin and bare it. The nurses and doctors are doing it all the time, so we really don't need to be too embarrassed. Easier said than done, but it's true.It is very helpful to have an idea of what the whole process will entail, so we are grateful for your input. Hope you will stay in contact with the board.


----------



## NancyCat (Jul 16, 1999)

I've had Dr's look at, in and around my entire body w/emphasis on my bowel. But I would have to draw the line at actually being observed pooping. I can tolerate alot of things but not that.I think I must have "shy bowels" and I'm not the only person like this either. Also my gastro had told me that even if I was worked up for pelvic floor issues (I guess pooping tests can indicate this)in his opinion there isnt much effective treatment available. I know Dr's, nurses and techs are used to these tests and the people who take them, still I wouldnt, couldnt do it.


----------



## 17176 (Mar 31, 2005)

i respect your decision nancy everyone is different, personally i would do it if it meant i was going to benefit from it..Before i was diagnosed with ibs (i had it for a few yrs before i was given a diagnoses) id have ran a mile if it was suggested that i had this precedure done, not the case now im past caring, i guess it has something to do with the job i used to do, and ive seen more bums than most peeps...


----------



## Guest (Nov 3, 2005)

Nah - should think my ex (god bless very very gay) boss had seen more!!!Sue


----------



## 20250 (Jul 14, 2005)

Thanks so much for your input Jon, it's nice to here from someone who actually does this stuff. One question, When You say extremely effective, you mean it absolutely will give a yes or no answer to a problem in this area as compared to other tests, or that a high percentage of peeps are finally getting helped?


----------



## 20378 (Nov 3, 2005)

My pleasure. I will say that depending on the doctor you talk to some don't even know about defecography, while it has been around for quite a long time. It perhaps is because it's rather taboo maybe, I don't really know. The test is commonly done on women (men get it done as well, though) because they can have more problems that the test can diagnose (giving birth is part of the reason). Prolapses of the rectum, pelvic floor issues, rectoceles, etc can be diagnosed with this test. In many of the cases I've seen and done a woman is having problems with retention or pooping accidentally when walking around. What happens is the rectum pushes anteriorly into the vagina, allowing stool to remain in a sort of pocket created by the push, the woman uses the bathroom and can never really go enough it seems to her. Some say they need to use the bathroom, but when they go, nothing comes. One could call this constipation. It's not really, it's more that they feel the need to go, due to stool residing close the the rectal spincter, pushing on the nerves and sending the signal to the brain that they need to go. When they go, there isn't anything there really to defecate, so they say they are constipated. Now we come to the case of the person walking around and loosing stool accidentally. This is a VERY concerning problem as you can imagine for people. Some say they find bits of stool in their underware that they were unaware of defecating, or that bits fall out of their pants in public without them realizing other than the feel of the stool falling down their pant leg. Gross, but a reality for some people. A defecogram (which is the actual name of the test. The study of which is defecography) is useful in determining why this is happening. I don't know any figures of success rates, only from my own experience and seeing the images that we create through it are quite educational and show these poor patients WHY what is happening is happening. The surgeons take it from there. I find a lot of the exams we do are postitive probably due to the fact that most people will not get this test done unless they seriously and truly have a malfunction of the rectum, which is manifested by their unsupportable sysmptoms over such a long period of time. (I've had patients that come to get a barium test done that end up refusing the exam when they find out what it is.... they always show back up in a few months when they really just HAVE to find out what to do about their problem). Cheers


----------



## 20250 (Jul 14, 2005)

Thanks for sharing these examples... Very informative.


----------



## SpAsMaN* (May 11, 2002)

jontonio,can you visualize the sigmoid with a defecography?Do you use a paste who is introduce while the patient strains the probe out?Thanks you for your input.


----------



## ClareM (May 12, 2003)

Joolie, have you checked out the link Arnie W posted to where I described my proctogram (as it's called in the UK) in detail? I know that you're in Scotland, whereas I had mine done in Harrow but I imagine that experiences of this test in the UK would be very similar to each other and may not be the same as in the US or elsewhere.As you can see from my account, although I absolutely dreaded the test, it wasn't anywhere near as horrible or humiliating as I'd expected it to be. For a start, it's only barium that you have to evacute, they're not watching you actually passing stool, nor do they look and see whether any stool came out too afterwards. Indeed, they're not actually watching you when you evacuate the barium, just the x-ray images of the inside of your rectum on the monitor. Because of the danger of radiation exposure for radiographers, etc. no one is actually in with you while you evacuate the paste. They're behind their protective screen where they can't see you. Because of the noise of the x-ray equipment, they wouldn't even be able to hear if you passed wind as you tried to pust the barium out.The test didn't hurt at all. The barium was injected into my rectum with a syringe (without a needle obviously). There was no catheter or balloon for this test, although I've had that for a different test. No barium was injected into my vagina or bladder and there definitely wasn't a video camera. I'd been really worried that there would be one because my consultant (from a different hospital) had said he thought there might be but, when I asked the people at St. Mark's about it, they said that they don't use video any more because x-ray technology has advanced.For me it certainly was a useful diagnostic test because it revealed a rectocele, a mucosal prolapse and an anismus. If you have evacuation problems, your doctors would probably find this test very useful.Love,ClareM


----------



## Arnie W (Oct 22, 2003)

So it could be a useful tool for helping with incomplete evacuation?Does anyone know what causes IE? I have frequent daily bowel movements, but usually have a stubborn remnant which sits in the rectum and doesn't want to budge. I think that's why I get lots of gas. It is unnatural to have stool sitting in the rectum all the time.


----------



## 17176 (Mar 31, 2005)

yes thanks clare and to you arnie


----------



## ClareM (May 12, 2003)

Arnie, it's definitely a good test for identifying the cause of incomplete evacuation, although evacuation difficulties can still be difficult to treat even once the cause is found, depending on what the cause is and how severe it is.I'm sure there are other causes of incomplete evacuation but one would be a rectocele. Some of the stool can get stuck in the rectocele and then it can be very difficult to get it out.If someone's difficulty in evacuating their bowels is caused by a rectocele, a prolapse or an anismus (a problem with co-ordinating the rectal muscles) the test should show it. There might be other problems that the test would show too. Those three are just the ones my doctors found from doing the test on me.Joolie, good luck if you do have a proctogram.Love,ClareM


----------



## Arnie W (Oct 22, 2003)

Thanks, Clare. My mother has a prolapse. I might ask my longsuffering doctor if he knows about the test.


----------



## 21078 (Oct 1, 2005)

Ok - I had a defegram recently (my second) at Beth Israel Hospital in Boston. All I can say is that you just gotta remember that all the radiologists and doctors also poop, and that you are there for a medical procedure!At Beth Israel everyone was kind, professional and made me feel at ease. Also, they had a "comfortable" toilet chair to sit in on the x-ray device.My first experience at Boston Brigham and Woman's was a bit weirder .... all the personell were super, but the setup to sit on was unstable and I had to balance myself constantly to prevent falling off the x-ray machine.


----------



## 17176 (Mar 31, 2005)

hi and welcome no go


----------



## 21078 (Oct 1, 2005)

Joolie,Thanks - I'm really not "new" - just don't post that much, no computer in the bathroom, and I guess the bb software changed.


----------



## cat crazy (Jan 28, 2002)

> Originally posted by ClareM:For me it certainly was a useful diagnostic test because it revealed a rectocele, a mucosal prolapse and an anismus. If you have evacuation problems, your doctors would probably find this test very useful.ClaireM. What treatment is your doc recomending or providing for this problem. And have you started any treatment for these problems?


----------



## ClareM (May 12, 2003)

Hannah, I'd already had my mucosal prolapse treated twice during the last few years - first by banding (like they do to haemorrhoids) and the second time with an injection of something I can't remember the name of to reattach the mucosal layer to the bowel wall. Unfortunately, the proctogram showed that it had returned again so I probably need to have it stapled.







My rectocele isn't very large at the moment but it's large enough to cause me problems and I might need to have an operation to insert a sort of sling to counteract the rectocele. Unfortunately both operations require a general anaesthetic and my husband and I are currently trying for a baby so my specialists want to wait until after I've given birth before doing the operations. It also makes sense to wait until afterwards because pregnancy could make the problems worse. Unfortunately, we have fertility problems so I've no idea when I'll ever get pregnant (let alone give birth) so I don't know how long I'm going to have to wait before I can get my mucosal prolapse and rectocele fixed.







For the anismus, I had biofeedback, which basically entailed me doing a lot of pelvic floor exercises to try to strengthen my pelvic floor muscles, being careful to make sure that I adopt the correct position and use the correct muscles when I empty my bowels and, at each biofeedback session, having an inflatable balloon inserted into my rectum and then having to 'poo' it out to demonstrate my evacuation technique to the therapist. My technique is now fine and my pelvic floor muscles are stronger than they had been but I still have my evacuation problems because of my rectocele and mucosal prolapse.Love,ClareM


----------



## cat crazy (Jan 28, 2002)

ClareM. Here's wising you all the very best for starting your family. It is best to have the surgeries after the baby as recommended. At least your tests are done and over with as that is an ordeal in itself. And they have solutions for fixing the rectocele and prolapse so thats also something positive to think about.Love


----------



## SpAsMaN* (May 11, 2002)

Does anybody knows if they evaluate the sigmoid with the defecography????


----------



## 17176 (Mar 31, 2005)

that i could'nt tell you spas


----------



## ClareM (May 12, 2003)

> quote:Originally posted by hanna:ClareM.Here's wising you all the very best for starting your family.


Thank you, Hanna







Spasman, As far as I know, the proctogram I had was used only to examine my rectum, not my sigmoid colon.Love,ClareM


----------



## 13604 (Jun 30, 2006)

> quote:Originally posted by jontonio:I find these postings facinating. I work in health care, I am not a doctor, but have done and will soon be starting up again defecograms (proctography, defecography, etc-mostly all the same) once our department has all the necessary equipment. From a health care viewpoint, yes, defecography is a invasion of your personal privacy (a tube is inserted into the rectum and a barium mixture injected therethrough; it's not an exam most people are excited to hear about). But I can give you some pointers regarding this exam. First off, it sounds like a strange exam, but the diagnostic benefits are incredible. It is a very serious exam and one should prepare themselves physically as well as emotionally and mentally (some people just can't take a dump in front of others). It's important to get over this... try. The barium is pushed through a tube into your rectum (injected sounds like it hurts). It's important that you relax and let it flow in... you will feel full, like you need to make a bm, just relax and hold onto the tube in your rectum (the tube typically has a ballon to help retain it's place, but it is important for the patient to try not to let it shoot out accidentally-it does happen). Breath deep and relax, it's a very simple procedure and will be over before you know it. The people doing it will try to maintain your privacy to the highest extent possible, but you do need to be aware of the need for certain exposure (ie to place the tube into the rectum and put the barium in the vagina for women-a practice done in some departments). You will be filled with not much barium, but it may feel like a lot, don't worry, barium will not cause any damage and will be defecated very soon. Now we come to the videotaping of the exam. Generally still x-rays are taken during the exam to show prolapses and rectoceles among other conditions, as well as a video tape to review the entire exam is very useful. No one there is doing the exam because they love doing it. Quite simply we're here for you, we understand, we've been there before (most everyone I know that works as a nurse or technician has personally gone through what you're going through and that is why they are in the field that they are in...That is why *I* do what I do). This exam is there to help you be diagnosed in order to get the proper treatment to correct the problem; among the many baruim studies (ie barium enemas, Small bowel follow throughs SBFT, Upper GI Studies) this is an extremely effective and useful exam for rectal problems. Hope it goes well.-Jon


Hello guys,I'm having this procedure done next week at the Sand Lake Hospital in Orlando FL. I would like to know if I should take a laxative the night before,like MOM, to empty my bowels. I have to be at the hospital at 1pm. Is it ok to have breakfast that morning? The hospital mailed me some paper about this procedure and I read that I need to drink an 8oz barium. I never heard about having to drink anything for this procedure before. Can somebody help on this? I want to know what to expect so I can be mentally and physically ready for this procedure.Thank you for you help and support.Blessings,Abi


----------



## SpAsMaN* (May 11, 2002)

No laxative prior to the exam as fas as i know.You drink the barium potion one hour before they fill your rectum with barium.I told the radiologist that i was able to introduce the tube in my ass so he didn't had to push it in.


----------



## 13711 (Jul 27, 2006)

I first read about this procedure on another string from this site and it made a huge difference in my attitude going into the procedure. I think I might have refused to do the test had I not read about it first! I have recently had this test as well as an "anal symmetry" I think it was called and a sitz marker study. Without the defagram (or whatever it's called) the OB/GYN nor the COLON/RECTAL specialist would have been able to surgically remove a huge rectocele. My body worked around the problem for over four years, yet no doctor could figure it out until one peek at the defagram and the entire problem was extremely obvious! For me, I had to drink two barium upper GI's (I think it was a mistake on the part of the X-RAY dept) and then they gave me a barium enema plus injected barium by syringe into my vagina. The radiologist was so surprised, he asked if I minded if he got his colleagues to see it as well, since he said I was so good natured and not worried about the embarrassment of evacuating in front of the three people already there! They put me in for surgery quickly to see if the repair might allow my colon to function normally again soon. Right now, it seems my bm's can't quite figure out where to go and the nerves alerting me to the fact that I need "to go" have also forgotten how to work. I'm still on the road to recovery, but if anyone wants to discuss it and ask questions...feel free to email me at mcclary###one.net .


----------



## 13604 (Jun 30, 2006)

Thank you SpAsMan and Justme for the replies, very helpful.http://www.med.umich.edu/1libr/aha/umdefecography.htmI was reading here that I might have to either complete 2 Fleets enemas or drink one bottle of citrate of magnesium.Did you guys have to do that? How long do I have to keep the barium inside?OMG, what if I have to pass gas while they are working on me? or worst yet, what if I have to poop(BM)? I'm getting really nervous about this test.I have to try to relax about this. I can't wait to get this over with...Blessings,Abi


----------



## SpAsMaN* (May 11, 2002)

> quote:I was reading here that I might have to either complete 2 Fleets enemas or drink one bottle of citrate of magnesium.Did you guys have to do that?


NO,but i wish i had.I was constipated that morning,as usual :/


----------

