Providing Trauma Informed Care During Anorectal Evaluation

• Published in: Current gastroenterology reports Vol. 25; no. 9; pp. 204 - 211
• Main Authors: Jagielski, Christina H., Naftaly, Jessica P., Riehl, Megan E.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2023; Springer Nature B.V
• Subjects: Adverse childhood experiences; Anal Canal; Domestic violence; Gastroenterology; Gastrointestinal Diseases; Health care; Health services utilization; Humans; Inflammatory bowel disease; Irritable bowel syndrome; Medicine; Medicine & Public Health; Mental health; Pain; Patients; Pelvis; Post traumatic stress disorder; Sex crimes; Sexual abuse; Topical Collection on Large Intestine; Trauma; Psychological trauma; Abuse; Psychogastroenterology; Anorectal manometry; Trauma-informed care; Medical trauma
• ISSN: 1522-8037; 1534-312X
• DOI: 10.1007/s11894-023-00879-4

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. Summary 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.