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      Investigating and Treating Fecal Incontinence: When and How

      Author(s): , ,
      Publication date Created:
      Publication date (Print):
      Journal: Canadian Journal of Gastroenterology
      Publisher: Hindawi Limited

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          Abstract

          Fecal incontinence is a common disorder in our aging population and can have profound effects on patient’s well-being. The present review examines the current understanding of fecal incontinence and provides a practical approach to the investigation and management of this condition. A special emphasis is placed on specialized testing, focusing on indications and impact on guiding management.

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          Most cited references38

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          U. S. Householder survey of functional gastrointestinal disorders

          Douglas Drossman, Zhiming Li, Eileen Andruzzi … (1993)
          Article 0 comments Cited 152 times – based on 0 reviews     Review now
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            Randomized controlled trial of biofeedback for fecal incontinence.

            Sally Redfern, Jenifer Barnett, Christine Norton … (2003)
            Behavioral treatment (biofeedback) has been reported to improve fecal incontinence but has not been compared with standard care. A total of 171 patients with fecal incontinence were randomized to 1 of 4 groups: (1) standard care (advice); (2) advice plus instruction on sphincter exercises; (3) hospital-based computer-assisted sphincter pressure biofeedback; and (4) hospital biofeedback plus the use of a home electromyelogram biofeedback device. Outcome measures included diary, symptom questionnaire, continence score, patient's rating of change, quality of life (short-form 36 and disease specific), psychologic status (Hospital Anxiety and Depression scale), and anal manometry. Biofeedback yielded no greater benefit than standard care with advice (53% improved in group 3 vs. 54% in group 1). There was no difference between the groups on any of the following measures: episodes of incontinence decreased from a median of 2 to 0 per week (P < 0.001). Continence score (worst = 20) decreased from a median of 11 to 8 (P < 0.001). Disease-specific quality of life, short-form 36 (vitality, social functioning, and mental health), and Hospital Anxiety and Depression scale all significantly improved. Patients improved resting, squeeze, and sustained squeeze pressures (all P < 0.002). These improvements were largely maintained 1 year after finishing treatment. Conservative therapy for fecal incontinence improves continence, quality of life, psychologic well-being, and anal sphincter function. Benefit is maintained in the medium term. Neither pelvic floor exercises nor biofeedback was superior to standard care supplemented by advice and education.
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              Effect of coffee on distal colon function.

              S R Brown, P A Cann, N W Read (1990)
              Ninety nine healthy young volunteers (58 men, 34 women, aged 17-27 years) answered a questionnaire concerning their bowel habit with particular reference to the effects of beverages. Twenty nine per cent (63% women) claimed that coffee induced a desire to defecate. The rectosigmoid motor responses to black, unsweetened coffee were then investigated by multiport manometry in 14 healthy-subjects (12 men, two women, eight of whom claimed coffee caused a desire to defecate (responders). Results revealed an increase in motility index within four minutes after ingestion of both regular and decaffeinated coffee (p less than 0.05) in the eight responders, but not in the six non-responders. The increase in rectosigmoid motility induced by coffee lasted at least 30 minutes. There was no increase in the motility index in any subject after a drink of hot water. These results suggest that drinking coffee can stimulate a motor response of the distal colon in some normal people.
              Article 0 comments Cited 41 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: Canadian Journal of Gastroenterology
                Abbreviated Title: Canadian Journal of Gastroenterology
                Publisher: Hindawi Limited
                ISSN (Print): 0835-7900
                Publication date Created: 2009
                Publication date (Print): 2009
                Volume: 23
                Issue: 4
                Pages: 301-308
                Article
                DOI: 10.1155/2009/905359
                PubMed ID: 19373424
                SO-VID: 6a86c0f3-06b1-47be-a4ac-02e422b0ae5e
                Copyright © © 2009
                License:

                http://creativecommons.org/licenses/by-nc/4.0/

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