In a defecography, the process of bowel evacuation (defecation) is recorded using an X-ray examination. This requires some preparation and the entire examination takes about 20 minutes.
The purpose of a defecography is to examine the anatomical conditions in the rectum and the function of defecation. Defecography can be used to diagnose many rectal diseases that can only be detected directly during the process of defecation.
These include, for example, defecation disorders such as fecal incontinence as well as pelvic floor and sphincter dysfunctions.
A defecography examines the processes in the bowel during the process of defecation. If diseases associated with this process are suspected, a defecography can provide important information.
These diseases include
Before a defecography is carried out, a medical consultation takes place.
The patient does not have to appear for the defecography on an empty stomach and no special dietary preparation is necessary. However, they should not take any laxatives in the days before the defecography.
Prior to the defecography, all hollow organs of the pelvis, i.e.
must befilled with X-ray contrast medium and contrasted. This allows the doctors to see exactly how these organs move during a bowel movement.
A defecography shows the processes of the organs involved during defecation © Henrie | AdobeStock
To do this, the patient must drink a cup of X-ray contrast medium 24 hours and two to three hours before the actual defecography. In women, the vagina must also be marked. This is usually done with a tampon soaked in contrast medium.
During the actual defecography, the rectum is first filled with X-ray contrast medium. The agent is introduced via a thin tube inserted through the anus.
The patient then sits on a special toilet chair in front of a fluoroscopic screen and empties their bowels.
During the pressing process and bowel evacuation, individual X-ray images are taken of the various functional states. Alternatively, the process of defecation can also be recorded as a video using X-rays, which is known as video defecography.
A defecography takes about 20 minutes in total and, apart from the onset of an urge to defecate, does not cause any pain. The recordings are then analyzed by a radiologist.
Complications occur very rarely during a defecography. Possible are
- Infections,
- bleeding or
- injuries
of the bladder, vagina or rectum. In addition, allergic reactions to the X-ray contrast medium can occur in very rare cases.
White stool deposits, which are harmless, may occur up to about a week after the defecography.
The images from a defecography make it possible to assess the movements of the organs and the motor function of the pelvic floor muscles. This enables doctors to identify any malfunctions during bowel evacuation.
Defecography images show, for example, whether
- the sphincter closes properly,
- the rectum straightens up for emptying and
- protrusions of the rectum (rectoceles), protrusions into the pelvis (enteroceles) or internal protrusions of the rectum (intussusceptions).
Based on these observations, the doctor can then narrow down the clinical picture and make a treatment decision.
