Vaginal delivery is one of the main causes of anal incontinence. While previously postpartum anal incontinence was attributed to neurological damage to the pelvic floor and the rectal sphincter, today we know that mechanical injury plays an important role, especially when symptoms start soon after delivery. Risk factors for postpartum fecal incontinence are: forceps delivery, nulliparity, birth weight over 4 kilograms and persistent occiput posterior presentation of the fetal head. Anal incontinence developed in 42% of women who had posterolateral episiotomy. Therefore, the main focus of the treating physician should be on prevention by avoiding birth trauma followed by early recognition and skilful correction.
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Dig Dis Sci
January 2025
Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Background: Chronic constipation, diarrhea, and fecal incontinence (FI) are prevalent with significant impact on quality of life and healthcare utilization. Thyroid dysfunction was recognized as a potential contributor to bowel disturbances in selected populations, but the strength/consistency of this association remain unclear.
Aims: To investigate the relationship between thyroid function and bowel health measures (constipation, diarrhea, and FI) in a nationally representative sample of the U.
Cureus
December 2024
Yoga and Cranial Osteopathy, ApsDEHA, Savona, ITA.
Childbirth is a dynamic process involving mutual adaptation between the maternal pelvis and the presenting fetal part. The ability of the pelvis to maintain optimal mobility during labor plays a crucial role in achieving favorable obstetric outcomes. The pubic arch angle (PAA) increases amplitude during pregnancy, showing pelvic tissue adjustment.
View Article and Find Full Text PDFInt Urogynecol J
January 2025
Department Development and Regeneration, Cluster Urogenital, Abdominal and Plastic Surgery, KU Leuven, Leuven, Belgium.
Introduction And Hypothesis: Pregnancy and delivery are commonly associated with ano-rectal dysfunction. In addition, vaginal delivery may impact both the structure and functionality of the pelvic floor. Herein, we systematically reviewed the literature for the potential association between levator ani muscle (LAM) avulsion and ano-rectal function after childbirth.
View Article and Find Full Text PDFAm J Gastroenterol
January 2025
Queen Mary University London, London, United Kingdom.
Introduction: The London classification provides standardization for characterization of disorders of anorectal function, although prevalences and clinical impact of these disorders are unclear.
Methods: An international research consortium was established, including five specialist centers. Prospective data were collected in consecutive adults referred for refractory chronic constipation (CC), fecal incontinence (FI) or coexistent CC/FI over 18 months.
Int J Radiat Oncol Biol Phys
January 2025
State Key Laboratory of Molecular Oncology and Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China; Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Shenzhen, China. Electronic address:
Objective: To explore differences in the effects of total neoadjuvant therapy (TNT) and preoperative concurrent chemoradiotherapy (CRT) on quality of life and functional outcomes in patients with locally advanced rectal cancer.
Methods: In the study, 591 patients with distal or middle-third, clinical primary tumor stage cT3-4 and/or regional lymph node-positive rectal cancer were randomly assigned (1:1) to receive short-term radiotherapy (25 Gy in five fractions) followed by 4 cycles of CAPOX (TNT group, n=297) or standard concurrent chemoradiotherapy (50 Gy in 25 fractions concurrently with oral capecitabine) (CRT group, n=294) before surgery. After a 6-year follow-up, the surviving patients were sent surveys, including the EORTC QLQ-C30, EORTC QLQ-CR29, and Wexner incontinence score questionnaires.
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