This article may have been created or edited in return for undisclosed payments, a violation of Wikipedia's terms of use. It may require cleanup to comply with Wikipedia's content policies, particularly neutral point of view. (January 2022) |
Satish Sanku Chander Rao is the J.Harold Harrison Distinguished University Chair in Gastroenterology at the Medical College of Georgia, Augusta University. He served as the former President of the American Neurogastroenterology and Motility Society and as Chair of the American Gastroenterological Association (AGA) Institute Council, Neurogastroenterology/Motility Section. [1] [2]
Satish Rao earned his medical degree from Osmania Medical College, Osmania University, Hyderabad, India. He completed Internal Medicine residency at the Sunderland and York Hospitals and Gastroenterology Fellowship training at the University of Sheffield and Royal Liverpool Hospitals, UK. He obtained his MRCP from the Royal College of Physicians (LON) and PhD from University of Sheffield, and is board certified in internal medicine and gastroenterology in USA. [3] [4]
Rao is the founding director of the Digestive Health Center, and the Digestive Health Clinical Research Center and Director, Neurogastroenterology/Motility at Augusta University Medical Center and as a Professor of Medicine (Tenure) at the Augusta University. He served the Chief of the Division of Gastroenterology, Director, GI Service Line, and Fellowship Program Director. Before that, he was a Professor of Medicine and Director of Neurogastroenterology and GI motility and biofeedback program at the University of Iowa Carver College of Medicine, Iowa City, IA. [5]
His research interests in the field of Neurogastroenterology/Motility have focused on gaining mechanistic insights, developing novel diagnostic tools and treatments for common motility disorders especially constipation with dyssynergic defecation, fecal incontinence, IBS, food intolerance notably fructose and fructan, gas and bloating and small intestinal bacterial and fungal overgrowth (SIBO/SIFO) and visceral pain. [6] [7] [8]
He is credited with identifying dyssynergic defecation, a problem that affects 1/3 of constipated patients and for developing its remedy, biofeedback therapy as well as new treatments, sensory adaptation training for rectal hypersensitivity. [9] [10] [11] He has pioneered several novel tests, translumbosacral anorectal magnetic stimulation for pelvic floor neuropathy, esophageal balloon distension for chest pain, fructose and fructan breath tests, and treatments such as home biofeedback for dyssynergia and translumbosacral neuromodulation therapy for fecal incontinence and bowel problems. [12] [13] [14] He developed the first method for examining the bi-directional gut and brain axis in humans. [15] [16] [17]
He has been awarded 4 patents. [18] [19] He is a federally funded principal investigator for 20 years and currently holds NIH UO-1 and RO-1 grants. [20] Dr. Rao has edited 10 books, including Handbook of GI Motility (2015), and Clinical and Basic Neurogastroenterology & Motility (2020). [21] He has published over 500 peer-reviewed articles with 20,500 citations, and an h-index of 82 and ilo index of 225. [22] He has been awarded 3 copyrights for patient-reported symptom diaries and digital Apps for fecal incontinence, constipation and gas/bloating. An astute clinician, Dr. Rao has been selected as one of the “Best Doctors in America” and as Americas’ Top Doctors for over 25 years. He has been invited to lecture in 35 countries as visiting professor. These include live demonstrations and workshops on anorectal manometry, esophageal manometry, and biofeedback therapy and novel TNT procedures, and to train peers globally.
Rao has received 3 meritorious honors from the American Gastroenterological Association (AGA), the AGA Distinguished Clinician Award, AGA Masters Award for Outstanding Clinical Research and AGA Distinguished Educator Award. He received the American College of Gastroenterology Auxiliary Research Award, the IFFGD Senior Clinical Investigator Award, the University of Iowa Regents Distinguished Award for Faculty Excellence, “Dr. PN Chuttani Oration”, the highest honor from Indian Society of Gastroenterology, 13 Distinguished National/International Professorships, Augusta University Distinguished Research Award and the J Harold Harrison, MD, Distinguished University Chair in Gastroenterology. [23]
Rao has edited ten books including Gastrointestinal Motility: tests and problem-oriented approach, ”Handbook of gastrointestinal motility and functional disorders”. Dr. Rao penned the book “G.I. Motility Testing: A laboratory and office handbook”. His latest book is “Clinical and Basic Neurogastroenterology/Motility which is the most comprehensive text in the field”. [24]
He has served as a Guest editor of the Gastroenterology Clinics of North America, and on the Editorial Boards of American Journal of Gastroenterology. American Journal of Physiology (GI), Current Gastroenterology Reports, and GI and Endoscopy News. [25]
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day.
Fecal incontinence (FI), or in some forms encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents, both liquid stool elements and mucus, or solid feces. When this loss includes flatus (gas), it is referred to as anal incontinence. FI is a sign or a symptom, not a diagnosis. Incontinence can result from different causes and might occur with either constipation or diarrhea. Continence is maintained by several interrelated factors, including the anal sampling mechanism, and incontinence usually results from a deficiency of multiple mechanisms. The most common causes are thought to be immediate or delayed damage from childbirth, complications from prior anorectal surgery, altered bowel habits, and receptive anal sex. An estimated 2.2% of community-dwelling adults are affected. However, reported prevalence figures vary. A prevalence of 8.39% among non-institutionalized U.S adults between 2005 and 2010 has been reported, and among institutionalized elders figures come close to 50%.
A rectal prolapse occurs when walls of the rectum have prolapsed to such a degree that they protrude out of the anus and are visible outside the body. However, most researchers agree that there are 3 to 5 different types of rectal prolapse, depending on whether the prolapsed section is visible externally, and whether the full or only partial thickness of the rectal wall is involved.
Functional gastrointestinal disorders (FGID), also known as disorders of gut–brain interaction, include a number of separate idiopathic disorders which affect different parts of the gastrointestinal tract and involve visceral hypersensitivity and motility disturbances.
Functional constipation, known as chronic idiopathic constipation (CIC), is constipation that does not have a physical (anatomical) or physiological cause. It may have a neurological, psychological or psychosomatic cause. A person with functional constipation may be healthy, yet has difficulty defecating.
A fecal impaction is a solid, immobile bulk of feces that can develop in the rectum as a result of chronic constipation. A related term is fecal loading which refers to a large volume of stool in the rectum of any consistency. Fecal impaction is a common result of neurogenic bowel dysfunction and causes immense discomfort and pain. Treatment of fecal impaction includes laxatives, enema, and pulsed irrigation evacuation (PIE).
The Bristol stool scale is a diagnostic medical tool designed to classify the form of human faeces into seven categories. It is used in both clinical and experimental fields.
The Rome process and Rome criteria are an international effort to create scientific data to help in the diagnosis and treatment of functional gastrointestinal disorders, such as irritable bowel syndrome, functional dyspepsia and rumination syndrome. The Rome diagnostic criteria are set forth by Rome Foundation, a not for profit 501(c)(3) organization based in Raleigh, North Carolina, United States.
Nutcracker esophagus, jackhammer esophagus, or hypercontractile peristalsis, is a disorder of the movement of the esophagus characterized by contractions in the smooth muscle of the esophagus in a normal sequence but at an excessive amplitude or duration. Nutcracker esophagus is one of several motility disorders of the esophagus, including achalasia and diffuse esophageal spasm. It causes difficulty swallowing, or dysphagia, with both solid and liquid foods, and can cause significant chest pain; it may also be asymptomatic. Nutcracker esophagus can affect people of any age but is more common in the sixth and seventh decades of life.
The rectoanal inhibitory reflex (RAIR) (also known as the anal sampling mechanism, anal sampling reflex, rectosphincteric reflex, or anorectal sampling reflex) is a reflex characterized by a transient involuntary relaxation of the internal anal sphincter in response to distention of the rectum. The RAIR provides the upper anal canal with the ability to discriminate between flatus and fecal material.
A sacral nerve stimulator is a small device usually implanted in the buttocks of people who have problems with bladder and/or bowel control. This device is implanted in the buttock and connected to the sacral nerve S3 by a wire. The device uses sacral nerve stimulation to stop urges to defecate and urinate by sending signals to the sacral nerve. The patient is able to control their bladder and/or bowel via an external device similar to a remote control.
Prucalopride, sold under brand names Resolor and Motegrity among others, is a medication acting as a selective, high affinity 5-HT4 receptor agonist which targets the impaired motility associated with chronic constipation, thus normalizing bowel movements. Prucalopride was approved for medical use in the European Union in 2009, in Canada in 2011, in Israel in 2014, and in the United States in December 2018. The drug has also been tested for the treatment of chronic intestinal pseudo-obstruction.
Anorectal manometry (ARM) is a medical test used to measure pressures in the anus and rectum and to assess their function. The test is performed by inserting a catheter, that contains a probe embedded with pressure sensors, through the anus and into the rectum. Patients may be asked to perform certain maneuvers, such as coughing or attempting to defecate, to assess for pressure changes. Anorectal manometry is a safe and low risk procedure.
Solitary rectal ulcer syndrome or SRUS is a chronic, benign disorder of the rectal mucosa. It commonly occurs with varying degrees of rectal prolapse. The condition is thought to be caused by different factors, such as long term constipation, straining during defecation, and dyssynergic defecation. Treatment is by normalization of bowel habits, biofeedback, and other conservative measures. In more severe cases various surgical procedures may be indicated. The condition is relatively rare, affecting approximately 1 in 100,000 people per year. It affects mainly adults aged 30–50. Females are affected slightly more often than males. The disorder can be confused clinically with rectal cancer or other conditions such as inflammatory bowel disease, even when a biopsy is done.
Anismus or dyssynergic defecation is the failure of normal relaxation of pelvic floor muscles during attempted defecation. It can occur in both children and adults, and in both men and women. It can be caused by physical defects or it can occur for other reasons or unknown reasons. Anismus that has a behavioral cause could be viewed as having similarities with parcopresis, or psychogenic fecal retention.
Obstructed defecation syndrome is a major cause of functional constipation, of which it is considered a subtype. It is characterized by difficult and/or incomplete emptying of the rectum with or without an actual reduction in the number of bowel movements per week. Normal definitions of functional constipation include infrequent bowel movements and hard stools. In contrast, ODS may occur with frequent bowel movements and even with soft stools, and the colonic transit time may be normal, but delayed in the rectum and sigmoid colon.
Dyssynergia is any disturbance of muscular coordination, resulting in uncoordinated and abrupt movements. This is also an aspect of ataxia. It is typical for dyssynergic patients to split a movement into several smaller movements. Types of dyssynergia include Ramsay Hunt syndrome type 1, bladder sphincter dyssynergia, and anal sphincter dyssynergia.
Transanal irrigation of the rectum and colon is designed to assist the evacuation of feces from the bowel by introducing water into these compartments via the anus.
Functional Lumen Imaging Probe (FLIP) is a test used to evaluate the function of the esophagus, by measuring the dimensions of the esophageal lumen using impedance planimetry. Typically performed with sedation during upper endoscopy, FLIP is used to evaluate for esophageal motility disorders, such as achalasia, diffuse esophageal spasm, etc.
Esophagogastric junction outflow obstruction (EGJOO) is an esophageal motility disorder characterized by increased pressure where the esophagus connects to the stomach at the lower esophageal sphincter. EGJOO is diagnosed by esophageal manometry. However, EGJOO has a variety of etiologies; evaluating the cause of obstruction with additional testing, such as upper endoscopy, computed tomography, or endoscopic ultrasound may be necessary. When possible, treatment of EGJOO should be directed at the cause of obstruction. When no cause for obstruction is found, observation alone may be considered if symptoms are minimal. Functional EGJOO with significant or refractor symptoms may be treated with pneumatic dilation, per-oral endoscopic myotomy (POEM), or botulinum toxin injection.
{{cite journal}}
: Cite journal requires |journal=
(help){{cite journal}}
: Cite journal requires |journal=
(help)