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Q2. Correct answer: A. CT scan.
Rationale
Given the change in bowel habits, colonoscopy in indicated to evaluate for inflammation. Anorectal manometry is helpful in evaluating sphincter function. Endoanal ultrasound can identify anal sphincter defects in the internal or external anal sphincter. Digital rectal exam is important in evaluating the anal area for skin tags, fissures, or scar. Digital exam can evaluate for resting anal sphincter tone and squeeze, pelvic floor descent and strength of the pelvic floor muscles. CT is unlikely to contribute to the evaluation of a functional disorder.
Reference
Bharucha AE et al. Gastroenterology. 2006 Apr;130(5):1510-8.
Q2. Correct answer: A. CT scan.
Rationale
Given the change in bowel habits, colonoscopy in indicated to evaluate for inflammation. Anorectal manometry is helpful in evaluating sphincter function. Endoanal ultrasound can identify anal sphincter defects in the internal or external anal sphincter. Digital rectal exam is important in evaluating the anal area for skin tags, fissures, or scar. Digital exam can evaluate for resting anal sphincter tone and squeeze, pelvic floor descent and strength of the pelvic floor muscles. CT is unlikely to contribute to the evaluation of a functional disorder.
Reference
Bharucha AE et al. Gastroenterology. 2006 Apr;130(5):1510-8.
Q2. Correct answer: A. CT scan.
Rationale
Given the change in bowel habits, colonoscopy in indicated to evaluate for inflammation. Anorectal manometry is helpful in evaluating sphincter function. Endoanal ultrasound can identify anal sphincter defects in the internal or external anal sphincter. Digital rectal exam is important in evaluating the anal area for skin tags, fissures, or scar. Digital exam can evaluate for resting anal sphincter tone and squeeze, pelvic floor descent and strength of the pelvic floor muscles. CT is unlikely to contribute to the evaluation of a functional disorder.
Reference
Bharucha AE et al. Gastroenterology. 2006 Apr;130(5):1510-8.
Q2. A 63-year-old female presents with a recent change in bowel habits. She previously had one formed bowel movement a day, but now has diarrhea three to four times a day with incontinence. She had prior normal colonoscopy 3 years ago.