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Your search term(s) "Fecal Incontinence" returned 48 results.

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Bowel Dysfunction and Its Relationship to Urinary Incontinence. IN: Newman, D.K.; Wein, A.J. Managing and Treating Urinary Incontinence. 2nd ed. Baltimore, MD: Health Professions Press, Inc. 2009. pp 129-174.

This chapter on bowel dysfunction and its relationship to urinary incontinence is from a book that provides a comprehensive review of the problem of urinary incontinence (UI) and overactive bladder (OAB) for health care providers of all disciplines—nurses, doctors, allied health professionals—who practice in primary care and who provide services to adults in acute care, rehabilitation centers, home care, and long-term care settings. This chapter reviews the most common bowel disorders that older adults with UI may experience: fecal (anal) incontinence (FI), chronic constipation, fecal impaction, and diarrhea. Clinicians are encouraged to develop a knowledge of the anatomy and physiology of the lower rectum in relation to the normal bowel; awareness of common bowel disorders seen in older adults; knowledge of stool type by history and physical examination; the ability to discuss constipation, FI, and fecal impaction management options with their patients; and a knowledge of evidence-based practice and relevant literature. Bowel regularity or irregularity has an impact on the bladder and its ability to empty. The chapter describes factors that contribute to bowel dysfunction, including insufficient dietary fiber, hemorrhoids, rectal surgery, poor fluid intake, ignoring the defecation urge, pregnancy, medications, chronic diseases, lack of physical activity, laxative abuse, and travel. Treatment options can address many of these factors. 7 figures. 2 tables. 83 references.

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Appendix A: The Rome III Diagnostic Criteria for the Functional Gastrointestinal Disorders. IN: Drossman, D., ed. Understanding the Irritable Gut: The Functional Gastrointestinal Disorders. McLean, VA: Degnon Associates, Inc. 2008. pp 183-199.

This appendix is from a book that helps doctors and patients better understand functional gastrointestinal disorders (FGIDs), with text based on information developed by the Rome Foundation to identify, classify, and treat these disorders. This appendix presents the Rome criteria for the diagnoses of FGIDs; the criteria were developed by teams of experts to define patients for scientific study and help practicing doctors more precisely identify the disorders. The disorders covered include functional heartburn, functional chest pain of presumed esophageal origin, functional dysphagia, globus, functional dyspepsia, postprandial distress syndrome, epigastric pain syndrome, belching disorders, chronic idiopathic nausea, functional vomiting disorders, cyclic vomiting syndrome (CVS), rumination syndrome in adults, irritable bowel syndrome, functional bloating, functional constipation, functional diarrhea, functional abdominal pain syndrome (FAPS), functional gallbladder and Sphincter of Oddi disorders, functional fecal incontinence, functional anorectal pain, and functional defecation disorders. The diagnostic criteria for both childhood and adult FGIDs are included, although the remainder of the appendix only focuses on adult disorders. Readers are cautioned that the criteria are not meant for self-diagnosis and that a confident diagnosis can only be safely arrived at after a careful history and physical examination by a doctor. The diagnostic criteria are scheduled to be updated again in 2012.

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Bowel Problems in Adults after Surgical Treatment for Childhood Hirschsprung’s Disease. Digestive Health Matters. 17(3): 7-9. Fall 2008.

This article considers the bowel problems that may be encountered in adults who had experienced surgical treatment for childhood Hirschsprung’s disease. In Hirschsprung’s disease, there is a lack of nerve cells in segments of the intestinal tract located in the colon and/or rectum; these ganglion cells are responsible for the normal wavelike motion of the bowel, and when they are missing, the stool stops and obstructions can occur. The authors briefly review the symptoms, diagnosis, and surgical treatment of Hirschsprung’s disease. They present two case reports of adults in their 20s who had undergone surgical treatment for their condition. The authors conclude that neuromuscular training with biofeedback, together with other behavioral or lifestyle approaches and medications, can be effective in the treatment of dyssynergic defecation or fecal incontinence in patients with bowel symptoms after surgery for Hirschsprung’s disease. Readers are referred to the International Foundation for Functional Gastrointestinal Disorders’ (IFFGD) website at www.aboutgiMotility.org for information about gastrointestinal motility. 2 figures.

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Hirschsprung’s Disease in Children and Adults. Digestive Health Matters. 17(2): 7-9. Summer 2008.

This article reviews Hirschsprung’s disease, a congenital condition in which people are born with a lack of nerve cells in the segments of the intestinal tract located in the colon or rectum. These abnormal segments produce obstruction that stops the movement of stool through the colon. The author reviews the epidemiology, symptoms, diagnosis, and treatment of Hirschsprung’s disease in adults and children. Diagnostic tests used to confirm the presence of Hirschsprung’s include biopsies, anorectal manometry, and barium enema. The treatment for this disease is surgical, but medical management is used to stabilize the patient before surgery. Surgery entails removal of the segment of bowel that lacks ganglion cells, followed by a pull-through of the remaining bowel down to the anus. The article concludes with a discussion of some of the complications that are encountered after surgical treatment of Hirschsprung’s disease, including obstructive symptoms, persistent internal anal sphincter dysfunction, fecal incontinence, and enterocolitis. This article was written for the American Neurogastroenterology and Motility Society (ANMS) and the International Foundation for Functional Gastrointestinal Disorders (IFFGD). A brief glossary of related medical terms is included.

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Pediatric Anorectal Disorders. Gastroenterology Clinics of North America. 37(3): 709-730. September 2008.

This article about pediatric anorectal disorders is from a special issue of Gastroenterology Clinics of North America that presents updates on disorders of the pelvic floor and anorectum. The authors report on the clinical, physiopathologic, diagnostic, and therapeutic aspects of the most common anorectal disorders in children, including constipation and fecal incontinence. They focus on the differential diagnosis between organic and functional constipation. Other clinical conditions are discussed, such as atopy, neurologic diseases, and anorectal malformations, in which chronic constipation may be an important clinical manifestation. Anorectal disorders are common in children and are usually mild and short-lived if the child receives prompt and adequate attention during the early phase of the disorder. Altered stool frequency and altered behavior with defecation are common presenting symptoms in children who have anorectal disorders. These alterations may be affected by several factors such as diet, social habit, convenience, parents’ cultural beliefs, interrelationships with the family, and daily timing of activities. In addition, the authors encourage clinicians to consider the age and degree of psychosocial development of the child for both diagnostic and treatment approaches. 3 figures. 2 tables. 92 references.

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Constipation and Disorders of Pelvic Floor Function. IN: Hauser, S., ed. Mayo Clinic Gastroenterology and Hepatology Board Review. 3rd ed. New York, NY: Informa Healthcare USA. 2008. pp 257-270.

This chapter on constipation and disorders of pelvic floor function is from a comprehensive textbook that provides an in-depth examination of essential knowledge in gastroenterology, hepatology, and the related areas of pathology, endoscopy, nutrition, and radiology. In the section on constipation, the author reviews the salient aspects of colonic motor physiology and pathophysiology, including function, regional differences in colonic motor function, motor patterns, colonic contractile response to a meal, colonic relaxation, colocolonic inhibitory reflexes, and serotonin and the gut. Other topics covered in this section include the assessment of colonic transit, a definition of constipation, and the clinical assessment, classification, and management of constipation The next section reviews disorders of pelvic floor function, including functional defecatory disorders and fecal incontinence; the physiology of defecation; diagnostic tests that may be used to confirm the presence of functional defecatory disorders; anorectal manometry; treatment options for functional defecatory disorders; the definition and etiology of fecal incontinence; patient assessment and diagnostic tests used to confirm fecal incontinence; and treatment strategies. The author stresses the potential impact of functional defecatory disorders on quality of life, noting that much can be accomplished by regulating bowel habits in patients with diarrhea or constipation. Diarrhea should be managed by treatment of the underlying condition. Biofeedback may be useful for fecal incontinence. Scheduled rectal emptying with suppositories of enemas is often useful for fecal impaction and overflow incontinence. 6 figures. 3 tables.

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Diagnosis and Management of Urinary Incontinence and Functional Fecal Incontinence (Encopresis) in Children. Gastroenterology Clinics of North America. 37(3): 731-748. September 2008.

This article about the diagnosis and management of urinary incontinence and functional fecal incontinence in children is from a special issue of Gastroenterology Clinics of North America that presents updates on disorders of the pelvic floor and anorectum. The authors note that the ability to maintain normal continence for urine and stools is not achievable in all children by a certain age. Gaining control of urinary and fecal continence is a complex process, and not all steps and factors involved are fully understood. Although normal development of anatomy and physiology are prerequisites to becoming fully continent, anatomic abnormalities—such as bladder exstrophy, epispadias, ectopic ureters, and neurogenic disturbances that can usually be recognized at birth and cause incontinence—will require specialist treatment, not only to restore continence but also to preserve renal function. The authors caution that most forms of urinary incontinence are not caused by an anatomic or physiologic abnormality and, hence, are more difficult to diagnose. Their management requires a sound knowledge of bladder and bowel function. The article covers the normal development of bladder and sphincter control, pathophysiology and classification of urinary incontinence, the epidemiology of urinary incontinence, the evaluation of children with daytime incontinence and constipation, the role of urodynamic studies, nonpharmacological treatments of urinary incontinence, pharmacologic therapy of urinary incontinence, functional fecal retention and functional retentive soiling, functional nonretentive soiling, and the treatment of fecal incontinence. 1 figure. 1 table. 99 references.

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Disorders of the Pelvic Floor and Anorectum. Gastroenterology Clinics of North America. 37(3): 1-764. September 2008.

This issue of Gastroenterology Clinics of North America presents updates on disorders of the pelvic floor and anorectum. The issue is designed to increase the interdisciplinary approach to these problems, which have heretofore often been dealt with in isolation by specialists from multiple disciplines. The issue includes current concepts on the pathophysiology of symptoms, innovative diagnostic tools, and evidence-based management strategies for pelvic floor problems. Fourteen chapters cover pelvic floor anatomy and applied physiology; manometric, sensorimotor, and neurophysiologic evaluation of anorectal function; the urodynamic evaluation of the bladder and pelvic floor; radiologic evaluation of pelvic floor disorders; dyssynergic defecation and biofeedback therapy; fecal incontinence and biofeedback therapy; surgical treatment of patients with constipation and fecal incontinence; hemorrhoids and fissure in ano; rectal prolapse, rectal intussusception, rectocele, solitary rectal ulcer syndrome, and enterocele; the diagnosis and management of ileal pouch dysfunction; functional and chronic anorectal and pelvic pain disorders; urinary and fecal incontinence in nursing home residents; pediatric anorectal disorders; and the diagnosis and management of urinary incontinence and functional fecal incontinence, called encopresis in children. Each chapter includes black-and-white photographs and concludes with a list of references. A detailed subject index concludes the volume.

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Fecal Incontinence and Biofeedback Therapy. Gastroenterology Clinics of North America. 37(3): 587-604. September 2008.

This article about fecal incontinence and biofeedback therapy is from a special issue of Gastroenterology Clinics of North America that presents updates on disorders of the pelvic floor and anorectum. The authors note that biofeedback as delivered in most clinical settings in Western medicine has been consistently reported to improve symptoms of fecal incontinence. Closer scrutiny of the elements of the intervention and controlled studies, however, have consistently failed to find any benefit of the biofeedback element of this complex package of care, nor has any superiority been found for one modality over another. They call for further well-designed and adequately powered randomized controlled trials. They stress that conservative interventions such as biofeedback, dietary modification, urge resistance training, and pelvic floor muscle training improve many patients with fecal incontinence to the point where most report satisfaction with treatment and do not wish to consider more invasive options such as surgery. 1 figure. 2 tables. 84 references.

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Incontinence: Quality of Life and Overcoming Barriers to Prevention, Diagnosis, and Treatment. Digestive Health Matters. 17(2): 5-6. Summer 2008.

This article reprints the text of a presentation given at the Digestive Disease Week in San Diego, CA, in May 2008 titled “Fecal Incontinence: New Perspectives on Early Detection, Current and Future Therapies.” The author presents a definition of health-related quality of life (HRQOL) and the potential negative impact of incontinence, including issues of whether the person feels inclined to seek medical help, the benefits from treatment, and the person’s ability to adapt to the demands of illness. The personal impact of incontinence may be further influenced by cultural, social, and psychological factors, including concepts of self-image, self-worth, and health expectations. Physicians are encouraged to take the lead and talk with their patients about bowel function and any problems with bowel control. Specific questions are provided to help physicians communicate more clearly with their patients. The author describes how patients sometimes adapt and accommodate to their incontinence, rather than seeking medical help. This can include withdrawal from activities, a limitation of food intake, and maintenance of close proximity to a bathroom. These behaviors can lead to isolation. The author concludes that better education and increased awareness among the public and providers about incontinence must be a priority to remove the stigma and the barriers to prevention, diagnosis, and treatment.

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