Investigations of rectal diseases and its indications

Dr Amrutha Manoharan
Rectal diseases are currently increasing in world wide and main diseases are Haemorrhoids, fistula, fissure, anal incontinence, anal polyp and carcinoma rectum. Investigations play a key role in the early diagnosis and further treatment of the disease.

The main investigations of rectal diseases are

1.DIGITAL EXAMINATION OF RECTUM AND ANAL CANAL
Digital examination of rectum is done by gloved index finger, properly lubricated with Vaseline and the patient should be in knee chest position, this gives information about the rectum and anal cannal. Haemorrhoids, fissure in ano, carcinoma, other growth in rectum can be find out by this method⁽¹⁾.

 2 .PROTOSCOPY
After doing the digital examination of rectum , a  protoscope is used to visualise the anal cannal and rectum this procedure help to diagnose vast majority of lesion in rectum and annal cannal ⁽¹⁾.

3.PROTOSIGMOIDOSCOPY
The  anal canal and, rectum and distal sigmoid colon can be Visualized through a sigmoidoscope⁽¹⁾.

4.BARIUM ENEMA
By this method large intestine can be visualised upto the Illeoceal junction. Evacuation should be achived by using Purgative and if needed a through bowel wash. Barium sulphate  suspention is given as enema.  The main diagnosis of  rectal disease like carcinomas,      Ulcerative colitis, diverticulitis , polyposis, strictures  And megacolon⁽¹⁾. Pednculated polyp arising from the   non-dependent wall of the colon give the appearance of Mexican hat sign. The term carpet lesion has also been Used to describe a flat lobulated lesion that manifests due.   To an alteration in surface texture of the bowel⁽³⁾.

 5. VIRTUAL COLONOSCOPY
Is a CT technique which generates high resolution 2D  Axial images from which 3D   images of colon resembling Those seen on colonoscopy are reconstituted, this 

Imaging procedure helps in detecting colonic lesions Including carcinomas.  ⁽¹⁾.

6. RECTAL BIOPSY
Rectal biopsy is a procedure used to extract a tissue sample from the rectum for laboratory analysis. The rectum is the lowest 6 inches of the large intestine, located just above the anal canal. The rectum’s purpose is to store the body’s solid waste until it’s released.

A rectal biopsy is an important tool for determining causes of abnormalities in the rectum. It helps to diagnose problems that are identified in screening tests such as anoscopy or sigmoidoscopy.

Diagnostic uses of a rectal biopsy

• identify the cause of blood, mucus, or pus in your stool
• determine the causes of tumors, cysts, or masses identified in a rectal screening test
• confirm a diagnosis of amyloidosis (a condition in which abnormal proteins called amyloids build up in your organs and spread through your body) make a definitive diagnosis of rectal cancer⁽⁴⁾ .

7.CAPSULE ENOSCOPY
To dectect small intestinal bleeding and obscure bleeds  This is a costly procedure⁽²⁾.

8. RADIONUCLEAR SCANNIG
^99mTc labelled sulphur colloid is used, they are mainly Used to detect the bleeding   sites⁽²⁾.

9. STOOL EXAMINATION
Mainly done in case of amoebiasis, bacillary  desentry and hookworm infestations⁽²⁾.

10. PLAIN RADIOGRAPHS
Mainly help to diagnose calcification in malignancies⁽³⁾.

11.ENDORECTAL ULTRASOUND
By doing this procedure , the rectal carcinoma appears  As hyperechoic mass with irregular borders interrupting The normal layer pattern. And also help to differentiate Villus adenoma from invasive carcinoma⁽³⁾.

12. CT COLANGIOGRAPHY
Examination of the entire colon, useful for detecting   Colorectal carcinoma⁽³⁾.

13. MRI IMAGINING
MRI can be used to detect and stage rectosigmoid tumors  More accurately than tumors in rest of the colon⁽³⁾.

14. PET/CT COLONOGRAPHY
Provides both anatomic and functional information, it Has been used for staging colon cancer and screening  Purpose⁽³⁾.

BIBILIOGRAPHY

1.Text book of medicine – Dr.k.v krishnadas
2.Manipal manual of surgery  – Dr.Anitha neleswar.
3.Textbook of radiology and imagining  – Dr.Satis.k.Bhargava
4.https;//www.healthline.com/health/rectal-biopsy.

Dr Amrutha Manoharan 
PG Scholar,Department Of Organon Of Medicine
Sarada Krishna Homoeopathic Medical College,
Kulasekaram , Tamil Nadu.