Fecal incontinence affects the quality of life, and causes significant embarrassment. Incontinence mostly affects elderly females. The majority of affected individuals do not seek medical attention because of embarrassment and unawareness of treatment options. Assessment of the severity of incontinence and its effect on the quality of life and evaluation of the anatomy and function of the pelvic floor, rectum and anus, are essential for the proper selection of treatment options. In mild to moderate incontinence, non-invasive treatment with diet and biofeedback may be worthwhile. Invasive treatments include minor procedures, such as "bulking" of the internal sphincter, using injectable agents or radiofrequency energy, and major surgical procedures such as neosphincter operations using the gracilis muscle or artificial bowel sphincter. This review focuses on the new treatment modalities of fecal incontinence.
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Int Urogynecol J
January 2025
Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada.
Introduction: Obstetric anal sphincter injuries (OASI) are associated with significant risk of complications, including pain, infection, and long-term pelvic floor dysfunction. The primary aim of this study was to evaluate the utility and acceptability of a postpartum telehealth consultation focused on pelvic floor health for patients after OASI.
Methods: This prospective study used a pre-post design comparing standard postpartum care versus standard postpartum care plus a telehealth urogynecology consultation focused on pelvic floor recovery.
Int J Colorectal Dis
January 2025
Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, 8200, Aarhus N, Denmark.
Purpose: Functional faecal incontinence (FFI) is a stigmatising condition for a child and parents and can be a challenge to treat even in tertiary centres. Transanal irrigation (TAI) is an emerging treatment with great success in refractory cases. We performed TAI with a substantially decreased amount of water used (low-volume TAI), yet no previous evidence exists on this treatment in children.
View Article and Find Full Text PDFWorld J Gastrointest Surg
January 2025
Department of Colorectal Surgery, Sir Run Shaw Hospital Affiliated with Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
Background: Despite improved survival rates in rectal cancer treatment, many patients experience low anterior resection syndrome (LARS). The preoperative LARS score (POLARS) aims to address the limitations of LARS assessment by predicting outcomes preoperatively to enhance surgical planning.
Aim: To investigate the predictive accuracy of POLARS in assessing the occurrence of LARS.
Gastro Hep Adv
October 2024
Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois.
Anorectal manometry (ARM) is a diagnostic test that utilizes pressure sensors to dynamically measure intraluminal anal and rectal pressures, thus providing an objective evaluation of anorectal functional parameters (tone, contractility, and relaxation), coordination and reflex activity, and sensation. ARM is a useful test for numerous indications including for the assessment and management of functional anorectal disorders such as fecal incontinence, functional defecatory disorders, and functional anorectal pain, preoperative assessment of anorectal function, and in facilitating/assessing response to biofeedback training. In addition, while many functional anorectal disorders present with overlapping symptoms (ie constipation, anorectal pain), ARM allows delineation of more specific disease processes and may guide treatment more effectively.
View Article and Find Full Text PDFCir Esp (Engl Ed)
January 2025
Unidad de Cirugía Colorrectal, Servicio de Cirugía General y Digestiva, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Low anterior resection syndrome is a common but underestimated complication after rectal cancer surgery that significantly impacts the quality of life of the surviving patient. It is characterized by symptoms such as fecal incontinence and voiding dysfunction and affects up to 90% of patients undergoing low anterior rectal resection. The etiology of the syndrome is multifactorial with no clear determining factor.
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