481SACZ-269 Yua 1

For Juae, who suffers from chronic constipation, a perverse anal esthetic procedure is performed. A large amount of petroleum jelly is applied to the fingers and rubbed into the anus while massaging for an extended period. Once the muscles have relaxed, the fingers are carefully inserted one by one, observing the patient's condition as more fingers are added. After confirming the state of the rectum with the fingers, a 50% glycerin solution is administered via enema using a glass syringe. To prevent leakage, the anus is plugged with a finger while pressure is applied to the lower abdomen with the palm to induce the urge to defecate. After sufficient time and restraint, she is made to excrete into a portable toilet. For the purpose of checking the condition of the stool, she is not allowed to go to the restroom. The patient is seated on an open-leg examination table, and her anus is re-expanded after defecation. The condition is checked with fingers before inserting rod-shaped instruments in order from thinnest to thickest. Once the anus has relaxed enough to accept a large foreign object, an anoscope is inserted. It is slowly opened, and light is shone into the intestine to observe the rectal condition. Finally, a 30cm-long rectoscope is inserted through the anus to visually inspect the deepest part of the rectum.