Science Alert: Bowel Function in Focus - Fecal Incontinence

Posted by Sofi Sigvardsson, May 23, 2017

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Fecal incontinence (FI) is a debilitating condition with a significant health burden. Although it has great clinical relevance and a profound impact on quality of life, there is still not much known about how to effectively treat this condition. This may be due to the diversity of causes of fecal incontinence, but may also be due to the lack of clinical investigation into possible treatment therapies.

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New research shows that a majority of patients with fecal incontinence regard the frequency of incontinence episodes as the most important factor to measure when investigating both severity and improvement of FI. One study explores fecal incontinence in children, as an effect of surgery and where enemas are considered the most effective therapy for FI.

Another study shows that children with functional fecal incontinence respond very well to transanal irrigation. Transanal irrigation is also shown to be effective against abdominal pain in patients with neurogenic bowel dysfunction.  

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Damaged anal canal as a cause of fecal incontinence after surgical repair for Hirschsprung disease - a preventable and under-reported complication.

https://www.ncbi.nlm.nih.gov/pubmed/27624566

Author and Origin
Bischoff A, Frischer J, Knod JL, Dickie B, Levitt MA, Holder M, Jackson L, Peña A. USA

Summary

A retrospective study of 10 patients operated on for Hirschsprung disease with fecal incontinence (FI). 54 patients had a damaged anal canal and 45 of these patients are on daily enemas.

Conclusions

It is important to preserve the anal canal when operating for Hirschprung.

Comments

Retrospective study investigating the possible complications of operating for Hirschsprung disease.

  


Transanal irrigation is effective in functional fecal incontinence.

https://www.ncbi.nlm.nih.gov/pubmed/28401344

Author and Origin 
Jørgensen CS, Kamperis K, Modin L, Rittig CS, Rittig S. Denmark

Summary

A retrospective study in 72 children with functional fecal incontinence treated with transanal irrigation (TAI). The study investigates the effect of TAI in children with functional constipation (FC) and functional fecal incontinence.

Conclusions

TAI seems effective in children with functional constipation and fecal incontinence. No clinical parameters seem to predict response to treatment.

Comments

Retrospective study investigating effectiveness of TAI in children with functional fecal incontinence.

This publication is described further in the highlight section.

  


Patient preferences for endpoints in fecal incontinence treatment studies.

http://onlinelibrary.wiley.com/doi/10.1111/nmo.13032/abstract;jsessionid=4E1FBB39820D73088D1F5F78DF37576F.f02t01

Author and Origin 

Heymen S., Palsson O., Simren M., Whitehead W.E. UK

Summary

A 2-step survey study investigating 28 and 186 patients’ definition of fecal incontinence (FI) and measurement of treatment success.

Conclusions

Frequency and urgency were the most important factors in defining FI. A reduction in frequency or complete cure were considered most important when measuring the success of FI treatment.

Comments

Survey study investigating the most important definition and success factors in patients with FI.

 


Peristeen Transanal irrigation system for the treatment of neuropathic bowel dysfunction and abdominal pain.

http://www.jurology.com/article/S0022-5347(17)34142-3/pdf

Author and Origin 

Palleschi G, Pastore AL, Salhi YA, Fuschi A, Velotti G, Leto A, Petrozza V, Carbone A. Italy

Summary

A prospective study with 20 patients with neurogenic bowel disorder (NBD) to investigate if transanal irrigation (TAI) can relieve symptoms of chronic abdominal pain.

Conclusions

Abdominal pain decreases significantly in this patient population. TAI is a safe and effective bowel management therapy.

Comments

Prospective study investigating the effect of TAI on abdominal pain in patients with NBD.


 

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This blog post is an extract of the Science Alert from May 2017 (76070-USX-1705)

Topics: Science Alert, Bowel management, Fecal incontinence