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Fecal incontinence

Hideaki Nishigori, Masayuki Ishii, Yujiro Kokado, Kouji Fujimoto, Hiroshi Higashiyama
BACKGROUND: The aim of this study was to evaluate the effectiveness of pelvic floor rehabilitation (PFR) for patients with bowel dysfunction after intersphincteric resection (ISR) and to compare the treatment response to that of patients after low anterior resection (LAR). METHODS: Thirty patients with postoperative bowel dysfunction for more than 6 months were enrolled and treated with PFR for 6 months. RESULTS: In the ISR group, significant improvements in the number of bowel movements and the use of antidiarrheal medications were observed, but no significant improvement was observed in the Wexner score (WS) and the fecal incontinence severity index (FISI)...
March 19, 2018: World Journal of Surgery
François Mion, Aurélien Garros, Fabien Subtil, Henri Damon, Sabine Roman
PURPOSE: High resolution anorectal manometry has been developed over the past years, as well as 3D high definition manometry (HDARM). However, the clinical impact of the results obtained with these new technologies remains to be determined. We thus analyzed various HDARM parameters of anal sphincter function and tested their capacity to discriminate between patients with constipation and those with fecal incontinence. METHODS: One hundred and fourteen consecutive patients underwent the same HDARM protocol (Medtronic), including 2 short duration voluntary anal contractions (5seconds) and 1 sustained (as long as possible) contraction...
March 15, 2018: Clinics and Research in Hepatology and Gastroenterology
Thais Villela Peterson, Rodrigo Ambar Pinto, G Willy Davila, Sérgio Carlos Nahas, Edmund Chada Baracat, Jorge Milhem Haddad
INTRODUCTION AND HYPOTHESIS: The Pelvic Floor Bother Questionnaire (PFBQ) was designed to identify the presence and degree of bother associated with common pelvic floor symptoms. The PFBQ can be used in clinical practice and for research purposes, but it is not available in Brazilian Portuguese. We aimed to validate a cross-culturally adapted Brazilian Portuguese version of the PFBQ. METHODS: A pilot-tested version of the PFBQ translated from English was evaluated with Brazilian patients suffering from pelvic floor disorders...
March 16, 2018: International Urogynecology Journal
T Brusa, D Abler, R Tutuian, C Gingert, J T Heverhagen, M Adamina, L E Brügger, P Büchler
BACKGROUND: A large proportion of age-related fecal incontinence is attributed to weakness or degeneration of the muscles composing the anal continence organ. However, the individual role of these muscles and their functional interplay remain poorly understood. METHODS: This study employs a novel technique based on the combination of MR imaging and FLIP measurements (MR-FLIP) to obtain anatomical and mechanical information simultaneously. Unlike previous methods used to assess the mechanics of the continence organ, MR-FLIP allows inter-individual comparisons and statistical analysis of the sphincter morpho-mechanical parameters...
March 15, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Ali Rezaie, Phillip Gu, Gilaad G Kaplan, Mark Pimentel, Ahmed K Al-Darmaki
Background: Inflammatory bowel disease (IBD) patients often continue to experience nonspecific gastrointestinal symptoms despite quiescent disease. Unlike non-IBD patients, IBD patients with dyssynergic defecation (DD) may present with various symptoms such as diarrhea, fecal incontinence, constipation, and rectal discomfort. Despite its importance and treatability, DD in IBD patients is not well recognized in practice. We conducted a systematic review and meta-analysis on the prevalence, diagnosis, and management of DD in IBD patients with ongoing defecatory symptoms...
February 24, 2018: Inflammatory Bowel Diseases
Michael Malone, Abdul Waheed, Samiullah Samiullah
Functional lower gastrointestinal disorders include irritable bowel syndrome (IBS), functional constipation, functional fecal incontinence, and functional anorectal pain. These disorders are common and have significant medical and social effects. They also can be challenging to manage. Patients with mild symptoms may benefit from lifestyle modification. IBS is classified into two subtypes: diarrhea-predominant and constipation-predominant. Depending on the IBS subtype and its likely etiology, patients may benefit from treatment with antispasmodics, antidepressants, guanylate cyclase-C agonists, chloride channel activators, antidiarrheal agents, probiotics, and/or antibiotics...
March 2018: FP Essentials
Franco Marinello, Miquel Kraft, Nuria Ridaura, Francesc Vallribera, Eloy Espín
INTRODUCTION: The treatment of anal fistula with the OTSC® (over-the-scope-clip) proctology device involves the placement of an elastic alloy clip called Nitinol on the internal fistula opening to achieve fistula healing. The aim of this study was to analyze preliminary results of this technique in a case series. METHODS: This was a retrospective analysis of patients who underwent OTSC® clip placement for fistula-in-ano treatment between June 2015 and March 2017 at a specialized colorectal unit...
March 7, 2018: Cirugía Española
Sandeep Singh, Balram Bhargava, Padma Vasantha, Rohit Bhatia, Hanish Sharma, Sujoy Pal, Peush Sahni, Govind K Makharia
PURPOSE: The primary objective of the study was to evaluate the safety and efficacy of a stool management kit (SMK) for containment of fecal incontinence in hospitalized bedridden patients. DESIGN: A single-group quasi-experimental study. SUBJECTS AND SETTING: Twenty bedridden adults who had at least 1 episode of fecal incontinence in the prior 24 hours participated in the study. The study setting was the neurological unit of the All India Institute of Medical Sciences in New Delhi, India...
March 2018: Journal of Wound, Ostomy, and Continence Nursing
Alexander C Peterson, Jason M Sutherland, Guiping Liu, R Trafford Crump, Ahmer A Karimuddin
PURPOSE: The Fecal Incontinence Quality of Life Scale (FIQL) is a commonly used patient-reported outcome measure for fecal incontinence, often used in clinical trials, yet has not been validated in English since its initial development. This study uses modern methods to thoroughly evaluate the psychometric characteristics of the FIQL and its potential for differential functioning by gender. METHODS: This study analyzed prospectively collected patient-reported outcome data from a sample of patients prior to colorectal surgery...
March 5, 2018: Quality of Life Research
Siobhan M Hartigan, Ariana L Smith
PURPOSE OF REVIEW: Pelvic floor disorders include urinary incontinence, pelvic organ prolapse, fecal incontinence, and other sensory and emptying abnormalities of the lower urinary and gastrointestinal tracts which are widely prevalent among women and largely undertreated. Many disparities exist among women with pelvic floor disorders which may affect prevalence estimates and treatment options offered. RECENT FINDINGS: Findings suggest that there are many disparities among women with pelvic floor disorders including age, race, inadequate knowledge, access to care, and socioeconomic status...
February 23, 2018: Current Urology Reports
Vikram Rangan, Shuji Mitsuhashi, Prashant Singh, Sarah Ballou, William Hirsch, Thomas Sommers, Judy Nee, Johanna Iturrino, Anthony Lembo
BACKGROUND & AIMS: Fecal urgency is a common symptom among patients with gastrointestinal disorders, but can also occur in healthy individuals with normal bowel habits. There have been few studies of fecal urgency in the general population. We performed a cross-sectional analysis of data from the National Health and Nurition Examination Survey (NHANES) to analyze the prevalence of and risk factors for this symptom. METHODS: We analyzed data from 4,676 persons who completed the Bowel Health Questionnaire from the NHANES, from 2009 through 2010...
February 20, 2018: Clinical Gastroenterology and Hepatology
Patricia Piccoli de Mello, Diego Andre Eifer, Elza Daniel de Mello
OBJECTIVE: To gather current evidence on the use of fiber for constipation treatment in pediatric patients. SOURCE OF DATA: Systematic review with meta-analysis of studies identified through Pubmed, Embase, LILACS and Cochrane databases published up to 2016. INCLUSION CRITERIA: Randomized controlled trials; patients aged between 1 and 18 years and diagnosed with functional constipation receiving or not drug treatment for constipation; articles published in Portuguese, English, Spanish, French, and German in journals accessible to the researchers...
February 21, 2018: Jornal de Pediatria
Pakeeza A Alam, Linda S Burkett, Brett A Clark, Nicola C White, Eshetu A Tefera, Lee A Richter
OBJECTIVE: The objective of this study was to compare disposable pads to Icon™ reusable underwear for the management of urinary incontinence on dimensions of quality of life and product performance. METHODS: This randomized cross-over trial included women with mild to moderate urinary incontinence as defined by baseline responses to the International Consultation on Incontinence Questionnaire-Short Form. Excluded were patients who had fecal incontinence or an active urinary tract infection...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Susan A Barr, Catrina C Crisp, Amanda B White, Shazia A Malik, Kimberly Kenton
OBJECTIVE: The aims of this study are to identify screening, treatment, and referral practices of primary care physicians (PCPs) for patients with pelvic floor disorders (PFDs) and evaluate awareness of the Female Pelvic Medicine and Reconstructive Surgery (FPMRS) subspecialty. METHODS: We conducted a cross-sectional survey of PCPs using a random sample of 1005 American College of Physicians members, stratified by demographic region. Electronic survey content included awareness of FPMRS certification, comfort diagnosing and treating PFDs, and PFD referral patterns for PCPs...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Constantinos Simillis, Nikhil Lal, Shengyang Qiu, Christos Kontovounisios, Shahnawaz Rasheed, Emile Tan, Paris P Tekkis
AIMS: Percutaneous tibial nerve stimulation (PTNS) and sacral nerve stimulation (SNS) are both second-line treatments for faecal incontinence (FI). To compare the clinical outcomes and effectiveness of SNS versus PTNS for treating FI in adults. METHOD: A literature search of MEDLINE, Embase, Science Citation Index Expanded and Cochrane was performed in order to identify studies comparing SNS and PTNS for treating FI. A risk of bias assessment was performed using The Cochrane Collaboration's risk of bias tool...
February 22, 2018: International Journal of Colorectal Disease
Matas Jakubauskas, Valdemaras Jotautas, Eligijus Poskus, Saulius Mikalauskas, Gintare Valeikaite-Tauginiene, Kestutis Strupas, Tomas Poskus
PURPOSE: Transanal endoscopic microsurgery (TEM) procedure could potentially influence the development of fecal incontinence later in life. The aim of our study was to assess long-term functional outcomes after TEM and to determine possible variables related to incontinence. METHODS: Patients, enrolled in a prospectively collected TEM operation database, were interviewed using a postal questionnaire. The questionnaire consisted of EuroQol (EQ)-5D-5L quality of life questionnaire, Wexner fecal incontinence grading scale, and additional questions about other perianal operations and obstetric history for women...
February 22, 2018: International Journal of Colorectal Disease
Ana María García Cabrera, Rosa María Jiménez Rodríguez, María Luisa Reyes Díaz, Jorge Manuel Vázquez Monchul, María Ramos Fernández, José Manuel Díaz Pavón, Carmen Palacios González, Francisco Javier Padillo Ruiz, Fernando de la Portilla de Juan
Fecal incontinence is one of the leading causes for the institutionalization of people in the last decades of life, associated with a great psychosocial and economic burden. The literature is scarce in this population group, due to the absence of universally accepted criteria to define "elderly patients" and difficulties in detection and diagnostic. The aim of this article was to conduct a narrative review of the main aspects related to fecal incontinence in older patients, providing management support...
February 18, 2018: Cirugía Española
Jaschar Shakuri-Rad, Arman Cicic, Jannah Thompson
OBJECTIVE: To investigate the use of intraoperative ultrasound during stage I InterStim® sacral lead placement. METHODS: A total of 40 patients were randomly assigned to undergo InterStim® lead placement utilizing fluoroscopy or ultrasound guidance. Patients were blinded for the duration of the study. The surgeon and staff were blinded until after induction of anesthesia. Patients met criteria for refractory overactive bladder, fecal incontinence, or both. The ICIQ-OABqol, OABSS, and FIQL validated questionnaires were used pre- and post-operatively...
February 21, 2018: Neurourology and Urodynamics
William E Whitehead
No abstract text is available yet for this article.
February 21, 2018: Digestive Diseases and Sciences
Lazaros I Sakkas, Theodora Simopoulou, Dimitrios Daoussis, Stamatis-Nick Liossis, Spyros Potamianos
Systemic sclerosis (SSc) is a chronic systemic disease characterized by microvasculopathy, autoantibodies, and extensive fibrosis. Intestinal involvement is frequent in SSc and represents a significant cause of morbidity. The pathogenesis of intestinal involvement includes vascular damage, nerve dysfunction, smooth muscle atrophy, and fibrosis, causing hypomotility, which leads to small intestinal bacterial overgrowth (SIBO), malabsorption, malnutrition, diarrhea, pseudo-obstruction, constipation, pneumatosis intestinalis, and fecal incontinence...
February 21, 2018: Digestive Diseases and Sciences
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