Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification.
- Abdominal ultrasonography (ultrasound examination of the abdominal organs) – for suspected ileus (intestinal obstruction), abscesses or tumors.
- Endosonography (endoscopic ultrasound (EUS); ultrasound examination performed from the inside, i.e., the ultrasound probe is brought directly into contact with the inner surface (in this case, the mucosa of the intestine) by means of an endoscope (optical instrument)) of the anorectum – when tumors, fistulas or enteroceles (intestinal hernia that protrudes into the vagina) are suspected.
- Abdominal plain radiography is a radiographic examination variant, which is also called abdominal overview radiography. The term “blank radiography” refers to the absence of contrast medium – in the case of suspected megacolon (massive enlargement of the large intestine (colon), which is not due to obstruction of the intestinal lumen).
- Rectosigmoidoscopy (reflection of rectum and S-shaped colon)/proctoscopy (rectoscopy; examination of the anal canal and the lower rectum / rectum) – on suspicion of hemorrhoids, anal stricture, fissure.
- Colonoscopy (colonoscopy) – should be performed in all elderly patients (> 50th LJ) to exclude a tumor.
- Colonic contrast enema (KE).
- If diverticulosis (change in the colon in the form of small protrusions of the intestinal wall), tumor is suspected.
- In children with chronic constipation (in V. a. Hirschsprung’s disease).
- Colonic manometry (analysis of phasic (manometry) and tonic (barostat) colonic motility (bowel activity)) – to detect severe basal and postprandial (“after a meal”) hypomotility (decreased bowel activity).
- Rectal barostat measurement (procedure in which a balloon inserted into the intestine is carefully and gradually filled with air so that the pressure in the balloon rises; patients indicate whether and, if so, what they feel in the process) – in cases where complaints are suspected to be based on increased or decreased perception of stimuli by the intestine (e.g., in patients with irritable bowel syndrome)
- Anorectal manometry (measurement of sphincter pressure values: in this method, a balloon is inserted into the anus to be squeezed out; the electronics connected to this balloon provide information about the sphincter pressure values and thus about the functionality of the rectum) – to determine the sphincter pressure and compliance of the rectum; preferably in combination with:
- Balloon expulsion test (evacuation of a rectal balloon during stimulated defecation (defecation maneuver)) – to detect voiding dysfunction.
- Defecography with barium contrast medium slurry (dynamic imaging of the anorectum at rest and during defecation (defecation); X-ray examination of the rectum) – for suspected rectocele (protrusion of the anterior wall of the rectum into the vagina) or internal rectal prolapse (rectal prolapse).
- Colon transit measurement (abdominal overview after taking radiopaque markers over a defined period of time) – mainly performed in cases of suspected anorectal voiding disorders.
- Sphincter EMG (measurement of nerve function of the sphincter muscle) – used to check the sphincter muscles (sphincter).
- Upper gastrointestinal tract (GIT; gastrointestinal tract) motility studies using:
- Gastroduodenojejunal manometry – if generalized motility disorder is suspected.
- Gastric emptying tests
- Small intestine transits
