Providing Trauma Informed Care During Anorectal Evaluation

Curr Gastroenterol Rep. 2023 Sep;25(9):204-211. doi: 10.1007/s11894-023-00879-4. Epub 2023 Jul 20.

Abstract

Purpose of review: Patients with a history of gastrointestinal (GI) conditions report high rates of psychological trauma. This review discusses the impact of previous trauma, as well as interactions with the medical system, on a patient's physical and mental health. Trauma-informed strategies for improving patient care during gastroenterology procedures are provided.

Recent findings: History of trauma increases risk of developing GI conditions and re-traumatization during sensitive anorectal procedures (i.e., anorectal manometry, balloon expulsion testing). Trauma-informed strategies include consistent trauma screening for all patients, obtaining consent before and during procedures, creating a safe environment, allowing for privacy, and post-procedure debriefing. Due to high rates of psychological trauma in the gastroenterology setting and the risk of medical trauma from the GI procedures themselves, having an established trauma-informed plan of care for all patients can reduce risk of iatrogenic harm and improve quality of care for patients with GI conditions.

Keywords: Abuse; Anorectal manometry; Medical trauma; Psychogastroenterology; Psychological trauma; Trauma-informed care.

Publication types

  • Review

MeSH terms

  • Anal Canal*
  • Gastrointestinal Diseases*
  • Humans