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Ortho term. Positive "braggers" maneuver

Posted By: Steady on 2009-06-23
In Reply to:

Subject: Ortho term. Positive "braggers" maneuver

causing buttock pain.


TIA!




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Subject: My ortho docs use the term of weightbearing views frequently... sm

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xx
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HISTORY OF PRESENT ILLNESS:  The patient is a 76-year-old male who over the last 2 years has had 4 incidence of fecal incontinence.  Usually this occurs when his stools are loose.  All 4 times, the patient had recently been out of town with the change of diet.  The patient had a colonoscopy 2 or 3 years ago that showed internal hemorrhoids only.  The patient has had not any rectal bleeding.  The patient does have a history of peripheral vascular disease and did have a carotid endarterectomy in 2002.  The patient has no known history of having a stroke.


 


IMPRESSION:


1.                   I doubt these episodes of incontinence represent colonic neoplasia.  The patient had a negative colonoscopy 2 to 3 years ago.


2.                   Possible sphincter dysfunction.


3.                   Possible lactose intolerance.


 


RECOMMENDATIONS:


1.                   Lactose free diet for 3 weeks.


2.                   Benefiber 1 heaping tbsp 8 ounces of water daily.


3.                   We will consider also recommending _____ maneuver.


4.                   We will not order another colonoscopy or any other workup at this time.


5.                   The patient will be seen again in 4 weeks.


 


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nm