Video library

Colorectal health, explained

43 short videos on the conditions patients ask about most — what they are, why they happen, and what treatment actually involves. Recorded and reviewed by Dr. Kamrava.

• Rectal Prolapse GuideRectal Prolapse occurs when the full thickness of the rectum wall turns inside out and sometimes sticks out through the anus. The condition can be internal (the rectum telescopes into itself) or external. Symptoms include a feeling of pressure or bulge, incomplete evacuation, mucus/stool leakage, and chronic straining. It is linked to the weakening of pelvic floor muscles and ligaments, often caused by chronic constipation, childbirth, or genetics. Diagnosis involves physical exam and specialized imaging, such as defecography, which provides a real-time view of the rectum's function during a bowel movement. Treatment is primarily surgical and is tailored to the patient. Surgical paths include the perineal approach (from below, higher recurrence, often for older/frail patients) and the abdominal approach (lower recurrence, often minimally invasive, such as ventral mesh rectopexy). The source notes there is no single "gold standard" operation.
• Long-Term Constipation: Is It a Slow Highway or a Blocked Exit?This content explains chronic constipation (symptoms lasting over three months) and divides it into two distinct types using the "highway analogy". 1) Slow Transit Constipation ("Slow Highway") means the colon muscles lack the "oomph" to push waste along. 2) Functional Outlet Obstruction (or dyssynergic defecation, the "Blocked Exit Ramp") means the pelvic floor muscles tense up instead of relaxing at the end of the line. Diagnosis must identify the type. Slow Transit is diagnosed using a SITS marker study (counting tiny plastic rings swallowed by the patient on an X-ray five days later). Functional Outlet Obstruction is diagnosed using specialized tests like Anorectal Manometry or Defecography (a live-action X-ray video). Treatment is specifically tailored: Slow Highway gets laxatives and prescription medications to speed up the colon; Blocked Exit gets muscle retraining, most commonly through Pelvic Floor Physical Therapy using Biofeedback. Surgery is considered a last resort for severe, unresponsive cases.
• Pelvic Bulges Explained: Rectum or Small Intestine?This resource addresses pelvic bulges (pelvic organ prolapse), which affect up to half of women who have had children. It focuses on two conditions: Rectocele (the rectum bulges forward into the vagina, a problem from the side) and Enterocele (the small intestine pushes down into the space, a type of internal hernia, a problem from above). Diagnosis relies on symptoms, as small rectoceles can be present in up to 93% of asymptomatic women. The gold standard test is Defecography, a specialized X-ray video that records the pelvic floor in action while the patient simulates a bowel movement to check the size of the bulge and if it traps stool. Surgery is recommended based on severe symptoms (e.g., needing to press on the vaginal wall to empty the bowels). Rectocele repair strengthens the weakened wall. Enterocele often requires a different procedure, such as a Sacrocolpopexy, to lift and secure the pelvic organs.