VHJOE- Editor's Column: Anatomy and Physiology of Rectal Function

Editor's Column: Anatomy and Physiology of Rectal Function

John C. Deutsch , M.D. (St. Mary's Duluth Clinic)

VHJOE Editor:

John Deutsch, MD
St. Mary's Duluth Clinic

Editorial Board:

Manoop S. Bhutani, MD
University of Texas
Medical Branch

William R. Brugge, MD
Massachusetts General Hospital

Peter R. McNally, DO
Denver, CO

Thomas J. Savides, MD
University of California,
San Diego

C. Mel Wilcox, MD
University of Alabama, Birmingham

Healthcare providers are frequently asked to address issues regarding rectal function, particularly constipation and fecal incontinence. Constipation is a preoccupation of many patients and can sometimes lead to problems such as ulceration of the rectum, as shown in the DAVE video clip "Colon - Solitary Rectal Ulcer Syndrome," available to view by clicking here.

Fecal incontinence is also common, but is less often discussed by patients. This problem is embarrassing, and can have devastating social consequences. The evaluation and therapy of subject with fecal incontinence can be difficult.

This issue of VHJOE contains a review by Dr. Satish Rao which discusses the management of patients with fecal incontinence. This article is intended to give our readers a physiologic and anatomic understanding of rectal function and provide ways for healthcare providers to assist patients with continence problems.

Familiarity with the anatomy of the rectum and anus is of critical importance in understanding evaluation and management issues as discussed by Dr. Rao. The anatomy of the rectum is demonstrated in the Featured Movie section of this issue of VHJOE, available by clicking here. In the previous issue of VHJOE, the Featured Movie highlighted the anal sphincter, available by clicking here.

A coronal view of the male pelvis with a link to the Visible Human Database is shown in Figure 1. Please take the time to explore the database and become familiar with the pertinent pelvic structures.

Figure 1: Click here to launch Interactive Atlas

We hope that the resources provided at VHJOE can help the reader to have a better understanding of the anatomy and physiology of rectal function, and the tests used to assess patients with incontinence.