A 56 y old woman who is known case of rectal cancer (T3N0) with previous history of surgery and chemo radiotherapy referred for evaluation of anemia. During her routine follow up visits, her oncologist informed about anemia (HB 10.2mg/dL, MCV 86fM), so request a full evaluation of GI tract including upper endoscopy and colonoscopy. She had not any complain except some fatigue and paleness. Her endoscopy was completely normal. During colonoscopy, the remained colon including site of anastomosis, descending, transverse, ascending and cecum sow completely normal but upon withdrawal of scope, there was brisk bleeding beside surgical sutures. The patient questioned about any bleeding and she mention rectal bleeding after sessions of rectal physiotherapy and rectal probe insertion for biofeedback therapy to prevent incontinence. So the cause of anemia diagnosed as rectal physiotherapy and biofeedback and the patient reassured and managed with intra venous iron (Ferinject 500mg). Her next follow up was totally normal without any complain.
D’Ancona C, Haylen B, Oelke M, Abranches‐MonteiroL,Arnold E, Goldman H, Hamid R, Homma Y,MarcelissenT,Rademakers K, Schizas A. The International Continence Society (ICS) report on the terminology for adult male lowerurinarytractandpelvic floor symptoms and dysfunction. Neurourology and urodynamics. 2019 Feb;38(2):433-77.
Thubert T, Cardaillac C, Fritel X, Winer N, Dochez V. Definition, epidemiology and risk factors of obstetric anal sphincter injuries: CNGOF Perineal Prevention and Protection in Obstetrics Guidelines. Gynecologie, obstetrique, fertilite & senologie. 2018 Oct 29;46(12):913-21.
Brochard C, Vénara A, Bodère A, Ropert A, Bouguen G, Siproudhis L. Pathophysiology of fecal incontinence in obese patients: A prospective case‐matched study of 201 patients. Neurogastroenterology & Motility.2017 Aug;29(8):e13051.
Pucciani F, Ringressi MN, Redditi S, Masi A, Giani I. Rehabilitation of fecal incontinence after sphincter- saving surgery for rectal cancer: encouraging results. Diseases of thecolon&rectum.2008Oct 1;51(10):1552.
Duelund-JakobsenJ,WorsoeJ, Lundby L, Christensen P, Krogh K. Management of patients with faecal incontinence. Therapeutic advances in gastroenterology. 2016 Jan;9(1):86-97.
Rogers, R.; Abed, H.; Fenner, D. Current Diagnosis and Treatment Algorithms for Anal Incontinence. BJU Int. 2006, 98, 97–106.
Bo K, Berghmans B, Morkved S, Van Kampen M. Evidence-Based physical therapy for the pelvic floor-E-book: bridging science and clinical practice. Elsevier Health Sciences; 2014 Nov 4.
Kalkdijk-Dijkstra AJ, van der Heijden JA, van Westreenen HL, Broens PM, Trzpis M, Pierie JP, Klarenbeek BR. Pelvic floor rehabilitation to improve functional outcome and quality of life after surgery for rectal cancer: study protocol for a randomized controlled trial (FORCE trial). Trials. 2020 Dec;21(1):1-2.
Alavinejad, P., & Abravesh, A. A. (2022). Rectal Physiotherapy: an Unusual Cause of Anemia During Rectal Cancer Follow Up. Iranian Journal of Colorectal Research, 10(2), 66-68. doi: 10.30476/acrr.2022.94262.1126
MLA
Pezhman Alavinejad; Ali Akbar Abravesh. "Rectal Physiotherapy: an Unusual Cause of Anemia During Rectal Cancer Follow Up", Iranian Journal of Colorectal Research, 10, 2, 2022, 66-68. doi: 10.30476/acrr.2022.94262.1126
HARVARD
Alavinejad, P., Abravesh, A. A. (2022). 'Rectal Physiotherapy: an Unusual Cause of Anemia During Rectal Cancer Follow Up', Iranian Journal of Colorectal Research, 10(2), pp. 66-68. doi: 10.30476/acrr.2022.94262.1126
VANCOUVER
Alavinejad, P., Abravesh, A. A. Rectal Physiotherapy: an Unusual Cause of Anemia During Rectal Cancer Follow Up. Iranian Journal of Colorectal Research, 2022; 10(2): 66-68. doi: 10.30476/acrr.2022.94262.1126