Ajay Kaul

75 statements · 3 topics

Featured statements

Oftentimes we see a megacolon, we assume or we presume that the tone and compliance is going to be abnormal, that the It's going to be abnormal and the surgeons, uh, right, correctly or wrongly, will say, oh well, this is a non-functional colon, let's remove it.
quote · Colorectal / ARM & Hirschsprung
Typically, we, our recommendations are if there's more than 40 to 50 centimeters of colon that's not working, does not have HAPCs, that's a dysfunctional colon.
quote · Colorectal / ARM & Hirschsprung
Manometry is really a catheter-based study of pressure changes within the lumen of the gut.
quote · Intestinal Rehab
There are three types of constipation: normal transit constipation, slow transit constipation (problem with neuromuscular integrity of colonic wall), and outlet obstruction or withholding (most common in anorectal malformation children).
clinical · Intestinal Rehab
The smart pill is a large capsule that measures pH, temperature, and pressure to assess transit from mouth to anus, but its size limits use to children approximately 10-12 years old or older.
clinical · Motility / Pseudo-obstruction
In megacolon, tone and compliance are usually abnormal, but colonic manometry may still show normal high-amplitude propagated contractions and transit may be normal.
clinical · Motility / Pseudo-obstruction

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Ajay's statements about Colorectal / ARM & Hirschsprung 25 statements

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Colorectal Collaboration: Neurogastroenterology/Motility Disorders

Quotation Manometry is really a catheter-based study of pressure changes within the lumen of the gut. Open
Statement Manometry is a catheter-based study of pressure changes within the lumen of the gut, involving visual pattern recognition of tracings to identify deviations from normal. Open
Statement Colonic motility has four key components: diameter of the colon, tone, compliance of the colonic wall, and contraction pressures (how strong the contractions are). Open
Statement In megacolon, tone and compliance are usually abnormal, but colonic manometry may still show normal high-amplitude propagated contractions and transit may be normal. Open
Quotation Oftentimes we see a megacolon, we assume or we presume that the tone and compliance is going to be abnormal, that the It's going to be abnormal and the surgeons, uh, right, correctly or wrongly, will say, oh well, this is a non-functional colon, let's remove it. Open
Statement There are three types of constipation: normal transit constipation, slow transit constipation (problem with neuromuscular integrity of colonic wall), and outlet obstruction or withholding (most common in anorectal malformation children). Open
Statement In a Sitz marker study, a patient should be able to pass all ingested radio-opaque markers in 5 days; markers remaining at 5 days indicate abnormal transit. Open
Quotation Usually, a patient should be able to poop out all of those markers in 5 days, but Some remaining at the end of 5 days like shown in the left picture here and the right, it kind of indicates that the transit may be abnormal. Open
Statement When Sitz markers are collected in the dilated rectum at 5 days, this is indicative of outlet obstruction or withholding. Open
Statement When Sitz markers are scattered all over the colon at 5 days, this is indicative of slow transit constipation. Open
Statement Scintigraphy studies colonic transit by tracking the geometric center of an ingested isotope and can identify specific colonic locations with transit issues. Open
Statement The smart pill is a large capsule that measures pH, temperature, and pressure to assess transit from mouth to anus, but its size limits use to children approximately 10-12 years old or older. Open
Statement There are two main types of colonic contractions: phasic (brief) or tonic (sustained), with segmental non-propagated contractions being the most common. Open
Statement High-amplitude propagated contractions (HAPCs) move stool along the length of the colon and correspond to what radiologists see on contrast enema as mass movement. Open
Statement The orthocolonic reflex (stimulus to colonic motility upon waking) and gastrocolonic reflex (stimulus upon eating) affect the timing of colonic contractions. Open
Quotation The majority of these originate in the proximal colon, and most do not really propagate beyond the midcolon. Open
Statement The majority of HAPCs originate in the proximal colon, and most do not propagate beyond the midcolon; fewer than 5% reach the rectum. Open
Statement Manometry catheters are typically placed during endoscopy, which allows evaluation of colonic mucosa, though interventional radiologists can also place them. Open
Statement The rectal motor complex appears as multiple small spikes on manometry tracings at the rectum. Open
Statement Segmental dysmotility on manometry can show HAPCs present in the right colon but absent in the left colon. Open
Statement If more than 40 to 50 centimeters of colon does not have HAPCs, that segment is considered dysfunctional colon. Open
Quotation Typically, we, our recommendations are if there's more than 40 to 50 centimeters of colon that's not working, does not have HAPCs, that's a dysfunctional colon. Open
Statement The first step in management is to maximize stimulant laxatives to ensure evacuation; if that fails, irrigation or enemas are tried before considering surgical interventions. Open
Statement In the presented case, duodenal and colonic manometry were normal, ruling out widespread dysmotility and confirming gastroparesis as the isolated abnormality. Open
Quotation And I would say the answer is yes, because you, you've ruled out a more widespread dysmotility. Open
Ajay's statements about Intestinal Rehab 25 statements

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Colorectal Collaboration: Neurogastroenterology/Motility Disorders

Quotation Manometry is really a catheter-based study of pressure changes within the lumen of the gut. Open
Statement Manometry is a catheter-based study of pressure changes within the lumen of the gut, involving visual pattern recognition of tracings to identify deviations from normal. Open
Statement Colonic motility has four key components: diameter of the colon, tone, compliance of the colonic wall, and contraction pressures (how strong the contractions are). Open
Statement In megacolon, tone and compliance are usually abnormal, but colonic manometry may still show normal high-amplitude propagated contractions and transit may be normal. Open
Quotation Oftentimes we see a megacolon, we assume or we presume that the tone and compliance is going to be abnormal, that the It's going to be abnormal and the surgeons, uh, right, correctly or wrongly, will say, oh well, this is a non-functional colon, let's remove it. Open
Statement There are three types of constipation: normal transit constipation, slow transit constipation (problem with neuromuscular integrity of colonic wall), and outlet obstruction or withholding (most common in anorectal malformation children). Open
Statement In a Sitz marker study, a patient should be able to pass all ingested radio-opaque markers in 5 days; markers remaining at 5 days indicate abnormal transit. Open
Quotation Usually, a patient should be able to poop out all of those markers in 5 days, but Some remaining at the end of 5 days like shown in the left picture here and the right, it kind of indicates that the transit may be abnormal. Open
Statement When Sitz markers are collected in the dilated rectum at 5 days, this is indicative of outlet obstruction or withholding. Open
Statement When Sitz markers are scattered all over the colon at 5 days, this is indicative of slow transit constipation. Open
Statement Scintigraphy studies colonic transit by tracking the geometric center of an ingested isotope and can identify specific colonic locations with transit issues. Open
Statement The smart pill is a large capsule that measures pH, temperature, and pressure to assess transit from mouth to anus, but its size limits use to children approximately 10-12 years old or older. Open
Statement There are two main types of colonic contractions: phasic (brief) or tonic (sustained), with segmental non-propagated contractions being the most common. Open
Statement High-amplitude propagated contractions (HAPCs) move stool along the length of the colon and correspond to what radiologists see on contrast enema as mass movement. Open
Statement The orthocolonic reflex (stimulus to colonic motility upon waking) and gastrocolonic reflex (stimulus upon eating) affect the timing of colonic contractions. Open
Quotation The majority of these originate in the proximal colon, and most do not really propagate beyond the midcolon. Open
Statement The majority of HAPCs originate in the proximal colon, and most do not propagate beyond the midcolon; fewer than 5% reach the rectum. Open
Statement Manometry catheters are typically placed during endoscopy, which allows evaluation of colonic mucosa, though interventional radiologists can also place them. Open
Statement The rectal motor complex appears as multiple small spikes on manometry tracings at the rectum. Open
Statement Segmental dysmotility on manometry can show HAPCs present in the right colon but absent in the left colon. Open
Statement If more than 40 to 50 centimeters of colon does not have HAPCs, that segment is considered dysfunctional colon. Open
Quotation Typically, we, our recommendations are if there's more than 40 to 50 centimeters of colon that's not working, does not have HAPCs, that's a dysfunctional colon. Open
Statement The first step in management is to maximize stimulant laxatives to ensure evacuation; if that fails, irrigation or enemas are tried before considering surgical interventions. Open
Statement In the presented case, duodenal and colonic manometry were normal, ruling out widespread dysmotility and confirming gastroparesis as the isolated abnormality. Open
Quotation And I would say the answer is yes, because you, you've ruled out a more widespread dysmotility. Open
Ajay's statements about Motility / Pseudo-obstruction 25 statements

Open the Motility / Pseudo-obstruction collection →

Colorectal Collaboration: Neurogastroenterology/Motility Disorders

Quotation Manometry is really a catheter-based study of pressure changes within the lumen of the gut. Open
Statement Manometry is a catheter-based study of pressure changes within the lumen of the gut, involving visual pattern recognition of tracings to identify deviations from normal. Open
Statement Colonic motility has four key components: diameter of the colon, tone, compliance of the colonic wall, and contraction pressures (how strong the contractions are). Open
Statement In megacolon, tone and compliance are usually abnormal, but colonic manometry may still show normal high-amplitude propagated contractions and transit may be normal. Open
Quotation Oftentimes we see a megacolon, we assume or we presume that the tone and compliance is going to be abnormal, that the It's going to be abnormal and the surgeons, uh, right, correctly or wrongly, will say, oh well, this is a non-functional colon, let's remove it. Open
Statement There are three types of constipation: normal transit constipation, slow transit constipation (problem with neuromuscular integrity of colonic wall), and outlet obstruction or withholding (most common in anorectal malformation children). Open
Statement In a Sitz marker study, a patient should be able to pass all ingested radio-opaque markers in 5 days; markers remaining at 5 days indicate abnormal transit. Open
Quotation Usually, a patient should be able to poop out all of those markers in 5 days, but Some remaining at the end of 5 days like shown in the left picture here and the right, it kind of indicates that the transit may be abnormal. Open
Statement When Sitz markers are collected in the dilated rectum at 5 days, this is indicative of outlet obstruction or withholding. Open
Statement When Sitz markers are scattered all over the colon at 5 days, this is indicative of slow transit constipation. Open
Statement Scintigraphy studies colonic transit by tracking the geometric center of an ingested isotope and can identify specific colonic locations with transit issues. Open
Statement The smart pill is a large capsule that measures pH, temperature, and pressure to assess transit from mouth to anus, but its size limits use to children approximately 10-12 years old or older. Open
Statement There are two main types of colonic contractions: phasic (brief) or tonic (sustained), with segmental non-propagated contractions being the most common. Open
Statement High-amplitude propagated contractions (HAPCs) move stool along the length of the colon and correspond to what radiologists see on contrast enema as mass movement. Open
Statement The orthocolonic reflex (stimulus to colonic motility upon waking) and gastrocolonic reflex (stimulus upon eating) affect the timing of colonic contractions. Open
Quotation The majority of these originate in the proximal colon, and most do not really propagate beyond the midcolon. Open
Statement The majority of HAPCs originate in the proximal colon, and most do not propagate beyond the midcolon; fewer than 5% reach the rectum. Open
Statement Manometry catheters are typically placed during endoscopy, which allows evaluation of colonic mucosa, though interventional radiologists can also place them. Open
Statement The rectal motor complex appears as multiple small spikes on manometry tracings at the rectum. Open
Statement Segmental dysmotility on manometry can show HAPCs present in the right colon but absent in the left colon. Open
Statement If more than 40 to 50 centimeters of colon does not have HAPCs, that segment is considered dysfunctional colon. Open
Quotation Typically, we, our recommendations are if there's more than 40 to 50 centimeters of colon that's not working, does not have HAPCs, that's a dysfunctional colon. Open
Statement The first step in management is to maximize stimulant laxatives to ensure evacuation; if that fails, irrigation or enemas are tried before considering surgical interventions. Open
Statement In the presented case, duodenal and colonic manometry were normal, ruling out widespread dysmotility and confirming gastroparesis as the isolated abnormality. Open
Quotation And I would say the answer is yes, because you, you've ruled out a more widespread dysmotility. Open