Chapter

Case 15

Alissa J. Walsh, Otto C. Buchel, Jane Collier and Simon P.L. Travis

in Oxford Case Histories in Gastroenterology and Hepatology

Published on behalf of Oxford University Press

Published in print March 2010 | ISBN: 9780199557899
Published online November 2012 | e-ISBN: 9780191753329 | DOI: http://dx.doi.org/10.1093/med/9780199557899.003.15

Series: Oxford Case Histories

Case 15

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A 50-year-old female schoolteacher presented to the outpatient department with a 12-year history of abdominal pain, straining at stool, a feeling of incomplete evacuation, and needing to return to the toilet several times after defecation. She often used per-vaginal digitation to assist the passage of stool and would spend up to 30 minutes on the toilet at any one time. She had seen a dietitian in the past and was on a high-fibre diet and using cracked linseed supplements, and occasional laxatives. Her bowels were currently opening about once daily, although ‘always with difficulty’. She described daily flatus incontinence, but denied any faecal incontinence. Prior to the onset of these symptoms, her bowels had opened every 1–2 days with no difficulty. She had a 13-year-old son (weighing 3700g [8lb 8oz] at birth), born by vaginal delivery with the aid of forceps. She remembered having a vaginal tear at this time, requiring sutures.

Chapter.  1498 words.  Illustrated.

Subjects: Gastroenterology

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