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Functional anorectal disorders.

Abstract

This report defines criteria for diagnosing functional anorectal disorders (ie, fecal incontinence, anorectal pain, and disorders of defecation). Functional fecal incontinence is defined as the uncontrolled passage of fecal material recurring for > or =3 months in an individual with a developmental age of > or =4 years that is associated with: (1) abnormal functioning of normally innervated and structurally intact muscles, and/or (2) no or minor abnormalities of sphincter structure and/or innervation insufficient to explain fecal incontinence, and/or (3) normal or disordered bowel habits (ie, fecal retention or diarrhea), and/or (4) psychological causes. However, conditions wherein structural and/or neurogenic abnormalities explain the symptom, or are part of a generalized process (eg, diabetic neuropathy) are not included within functional fecal incontinence. Functional fecal incontinence is a common, but underrecognized symptom, which is equally prevalent in men and women, and can often cause considerable distress. The clinical features are useful for guiding diagnostic testing and therapy. Functional anorectal pain syndromes include proctalgia fugax (fleeting pain) and chronic proctalgia; chronic proctalgia may be subdivided into levator ani syndrome and unspecified anorectal pain, which are defined by arbitrary clinical criteria. Functional defecation disorders are characterized by 2 or more symptoms of constipation, with > or =2 of the following features during defecation: impaired evacuation, inappropriate contraction of the pelvic floor muscles, and inadequate propulsive forces. Functional disorders of defecation may be amenable to pelvic floor retraining by biofeedback therapy (such as dyssynergic defecation).

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Mayo Clinic, Rochester, Minnesota, USA.

    , ,

    Source

    Gastroenterology 130:5 2006 Apr pg 1510-8

    MeSH

    Anus Diseases
    Defecation
    Fecal Incontinence
    Humans
    Rectal Diseases

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    16678564

    Citation

    Bharucha, Adil E., et al. "Functional Anorectal Disorders." Gastroenterology, vol. 130, no. 5, 2006, pp. 1510-8.
    Bharucha AE, Wald A, Enck P, et al. Functional anorectal disorders. Gastroenterology. 2006;130(5):1510-8.
    Bharucha, A. E., Wald, A., Enck, P., & Rao, S. (2006). Functional anorectal disorders. Gastroenterology, 130(5), pp. 1510-8.
    Bharucha AE, et al. Functional Anorectal Disorders. Gastroenterology. 2006;130(5):1510-8. PubMed PMID: 16678564.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Functional anorectal disorders. AU - Bharucha,Adil E, AU - Wald,Arnold, AU - Enck,Paul, AU - Rao,Satish, PY - 2005/03/02/received PY - 2005/11/03/accepted PY - 2006/5/9/pubmed PY - 2006/6/3/medline PY - 2006/5/9/entrez SP - 1510 EP - 8 JF - Gastroenterology JO - Gastroenterology VL - 130 IS - 5 N2 - This report defines criteria for diagnosing functional anorectal disorders (ie, fecal incontinence, anorectal pain, and disorders of defecation). Functional fecal incontinence is defined as the uncontrolled passage of fecal material recurring for > or =3 months in an individual with a developmental age of > or =4 years that is associated with: (1) abnormal functioning of normally innervated and structurally intact muscles, and/or (2) no or minor abnormalities of sphincter structure and/or innervation insufficient to explain fecal incontinence, and/or (3) normal or disordered bowel habits (ie, fecal retention or diarrhea), and/or (4) psychological causes. However, conditions wherein structural and/or neurogenic abnormalities explain the symptom, or are part of a generalized process (eg, diabetic neuropathy) are not included within functional fecal incontinence. Functional fecal incontinence is a common, but underrecognized symptom, which is equally prevalent in men and women, and can often cause considerable distress. The clinical features are useful for guiding diagnostic testing and therapy. Functional anorectal pain syndromes include proctalgia fugax (fleeting pain) and chronic proctalgia; chronic proctalgia may be subdivided into levator ani syndrome and unspecified anorectal pain, which are defined by arbitrary clinical criteria. Functional defecation disorders are characterized by 2 or more symptoms of constipation, with > or =2 of the following features during defecation: impaired evacuation, inappropriate contraction of the pelvic floor muscles, and inadequate propulsive forces. Functional disorders of defecation may be amenable to pelvic floor retraining by biofeedback therapy (such as dyssynergic defecation). SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/16678564/Functional_anorectal_disorders_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(06)00516-6 DB - PRIME DP - Unbound Medicine ER -