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Function and dysfunction of the colon and anorectum in adults: working team report of the Swedish Motility Group (SMoG).
Scand J Gastroenterol. 2009; 44(6):646-60.SJ

Abstract

Symptoms of fecal incontinence and constipation are common in the general population. These can, however, be unreliably reported and are poorly discriminatory for underlying pathophysiology. Furthermore, both symptoms may coexist. In the elderly, fecal impaction always must be excluded. For patients with constipation, colon transit studies, anorectal manometry and defecography may help to identify patients with slow-transit constipation and/or pelvic floor dysfunction. The best documented medical treatments for constipation are the macrogols, lactulose and isphagula. Evolving drugs include lubiprostone, which enhances colonic secretion by activating chloride channels. Surgery is restricted for a highly selected group of patients with severe slow-transit constipation and for those with large rectoceles that demonstrably cause rectal evacuatory impairment. For patients with fecal incontinence that does not resolve on antidiarrheal treatment, functional and structural evaluation with anorectal manometry and endoanal ultrasound or magnetic resonance (MR) of the anal canal may help to guide management. Sacral nerve stimulation is a rapidly evolving alternative when other treatments such as biofeedback and direct sphincter repair have failed. Advances in understanding the pathophysiology as a guide to treatment of patients with constipation and fecal incontinence is a continuing important goal for translational research. The content of this article is a summary of presentations given by the authors at the Fourth Meeting of the Swedish Motility Group, held in Gothenburg in April 2007.

Authors+Show Affiliations

Department of Internal Medicine, Umeå University Hospital, Sweden. pontus.karling@vll.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19191186

Citation

Karling, Pontus, et al. "Function and Dysfunction of the Colon and Anorectum in Adults: Working Team Report of the Swedish Motility Group (SMoG)." Scandinavian Journal of Gastroenterology, vol. 44, no. 6, 2009, pp. 646-60.
Karling P, Abrahamsson H, Dolk A, et al. Function and dysfunction of the colon and anorectum in adults: working team report of the Swedish Motility Group (SMoG). Scand J Gastroenterol. 2009;44(6):646-60.
Karling, P., Abrahamsson, H., Dolk, A., Hallböök, O., Hellström, P. M., Knowles, C. H., Kjellström, L., Lindberg, G., Lindfors, P. J., Nyhlin, H., Ohlsson, B., Schmidt, P. T., Sjölund, K., Sjövall, H., & Walter, S. (2009). Function and dysfunction of the colon and anorectum in adults: working team report of the Swedish Motility Group (SMoG). Scandinavian Journal of Gastroenterology, 44(6), 646-60. https://doi.org/10.1080/00365520902718713
Karling P, et al. Function and Dysfunction of the Colon and Anorectum in Adults: Working Team Report of the Swedish Motility Group (SMoG). Scand J Gastroenterol. 2009;44(6):646-60. PubMed PMID: 19191186.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Function and dysfunction of the colon and anorectum in adults: working team report of the Swedish Motility Group (SMoG). AU - Karling,Pontus, AU - Abrahamsson,Hasse, AU - Dolk,Anders, AU - Hallböök,Olof, AU - Hellström,Per M, AU - Knowles,Charles H, AU - Kjellström,Lars, AU - Lindberg,Greger, AU - Lindfors,Per-Johan, AU - Nyhlin,Henry, AU - Ohlsson,Bodil, AU - Schmidt,Peter T, AU - Sjölund,Kristina, AU - Sjövall,Henrik, AU - Walter,Susanne, PY - 2009/2/5/entrez PY - 2009/2/5/pubmed PY - 2009/10/9/medline SP - 646 EP - 60 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 44 IS - 6 N2 - Symptoms of fecal incontinence and constipation are common in the general population. These can, however, be unreliably reported and are poorly discriminatory for underlying pathophysiology. Furthermore, both symptoms may coexist. In the elderly, fecal impaction always must be excluded. For patients with constipation, colon transit studies, anorectal manometry and defecography may help to identify patients with slow-transit constipation and/or pelvic floor dysfunction. The best documented medical treatments for constipation are the macrogols, lactulose and isphagula. Evolving drugs include lubiprostone, which enhances colonic secretion by activating chloride channels. Surgery is restricted for a highly selected group of patients with severe slow-transit constipation and for those with large rectoceles that demonstrably cause rectal evacuatory impairment. For patients with fecal incontinence that does not resolve on antidiarrheal treatment, functional and structural evaluation with anorectal manometry and endoanal ultrasound or magnetic resonance (MR) of the anal canal may help to guide management. Sacral nerve stimulation is a rapidly evolving alternative when other treatments such as biofeedback and direct sphincter repair have failed. Advances in understanding the pathophysiology as a guide to treatment of patients with constipation and fecal incontinence is a continuing important goal for translational research. The content of this article is a summary of presentations given by the authors at the Fourth Meeting of the Swedish Motility Group, held in Gothenburg in April 2007. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/19191186/Function_and_dysfunction_of_the_colon_and_anorectum_in_adults:_working_team_report_of_the_Swedish_Motility_Group__SMoG__ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520902718713 DB - PRIME DP - Unbound Medicine ER -