[SACZ-269]

Yua Goto

Special anal esthetic treatment for Yua Goto, who suffers from chronic constipation. First, the therapist applies a generous amount of Vaseline to her fingers and carefully massages the anal area, gradually relaxing the muscles. Watching the patient's reactions, the therapist cautiously inserts fingers one by one, progressively increasing the number to stimulate deeper tissues. After assessing the condition inside the rectum manually, a 50% glycerin solution is administered via enema using a glass syringe. To prevent immediate evacuation, the therapist blocks the anus with a finger while applying pressure to the lower abdomen with the palm, provoking the urge to defecate. After making her endure sufficiently, the therapist guides her to defecate onto a portable commode, but does not allow her to move to the toilet in order to closely monitor the stool's condition. The patient is then seated on a gynecological table in an open-leg position, and after defecation, the anus is dilated once again. After manual inspection, rod-shaped dilators are inserted one after another, starting from the thinnest, until the anus becomes loose enough to accept thicker objects. Then, an anoscope is inserted and slowly opened to allow illumination of the rectal cavity, enabling close observation of the internal condition. Finally, a 30cm-long rectal endoscope is inserted through the anus to visually examine the deepest parts of the rectum.