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By Dr. med. Ernst Stein (auth.)

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Extra info for Anorectal and Colon Diseases: Textbook and Color Atlas of Proctology

Sample text

In addition, if there is the slightest suspicion of a work-related infection, the physician should expend every effort to be sure the employee is treated promptly and appropriately, and that potential causes for the exposure are addressed [17]. In Germany, there are highly specific rules about the use of protective clothing, including when it must be worn and how it should be cleaned and disinfected. In addition, an adequate supply of protective clothes, masks, hair covering, and disinfectant material must always be available.

It is remarkable that even when major portions of the ampulla are surgically removed, continence is maintained. When the sacral spinal cord is destroyed, the defecation reflex is lost. If the spinal cord is severed above the sacral level, the spinal defecation reflex is intact and defecation can still be controlled. The appropriate motor stimuli induced by contraction of the abdominal muscles is then lost or weakened, but it is not essential. Another important parameter is the anal reflex, which is control by the S5 spinal segment.

Often, surgical repair of essential anatomic structures is combined with postoperative training to restore and improve the physiological function of the closure mechanism. [4, 14, IS, 17, 18, 32, 33, 35, 41]. Electrostimulation is another passive conservative therapy for anal incontinence which may prove useful [6, 11,23,27,28,31,33,40,41,43,48]. In general, three degrees of anal incontinence are recognized: • 1st degree (mild form); Such patients occasionally have mild soiling of their underwear or unintentional release of gas.

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