- Faecal incontinence: investigation, treatment and management. [Journal Article]
- BJBr J Community Nurs 2018 Dec 02; 23(12):582-588
- Faecal incontinence (FI) is a hidden problem that is under-diagnosed, under-investigated and under treated. Up to 10% of adults can experience an episode of FI. The prevalence of FI in the adult popu...
Faecal incontinence (FI) is a hidden problem that is under-diagnosed, under-investigated and under treated. Up to 10% of adults can experience an episode of FI. The prevalence of FI in the adult population has been estimated at 0.8-6.2%. Recent North American research indicates a prevalence of 8.3% in adults living in the community. This article explores the reasons why adults can develop FI, the importance of assessment, what treatments are available and how intractable FI can best be managed.
- Bowel management in children with spina bifida. [Journal Article]
- JPJ Pediatr Rehabil Med 2018 Nov 19
- Spina bifida is a birth defect that commonly causes bowel and bladder dysfunction in children with a significant negative impact on quality of life and emotional wellbeing. Fecal continence improves ...
Spina bifida is a birth defect that commonly causes bowel and bladder dysfunction in children with a significant negative impact on quality of life and emotional wellbeing. Fecal continence improves satisfaction and the quality of life of both children and their caretakers. Bowel management in children with spina bifida is hampered by limited controlled studies and variable practice within different institutions and subspecialists. The goals of a successful bowel management program in children with spina bifida consist of predictable bowel movements, social continence, and eventual independence. Treatment options range from conservative interventions such as diets and oral laxatives that modify stool consistency and transit, to trans-anal irrigations and antegrade continence enemas that facilitate predictable recto-sigmoid emptying and provide a greater degree of independence. In children, the treatment approach should be implemented in the context of the child's developmental age in order to allow for optimum social integration with their age-appropriate peers. We present a review of a stepwise approach to bowel management in children with spina bifida and the challenges related to the proposed treatment options.
- Nouveaux traitements de l’incontinence anale. Une chirurgie mini-invasive de plus en plus innovante. [Journal Article]
- RPRev Prat 2016; 66(8):913-917
- New management of fecal incontinence. Fecal incontinence management requires complete medical and surgical team. Medications are crucial and improve majority of the patients? Surgical approach is def...
New management of fecal incontinence. Fecal incontinence management requires complete medical and surgical team. Medications are crucial and improve majority of the patients? Surgical approach is definitely limited to patients that remain uncompletely satisfied despite optimal medical management. Indications for surgery depend on diagnosis of rectal procidencia and sphincter defect. Rectopxy, sphincterorraphy, neuromodulation, antegrade colonic enemas are the main surgical strategies. Magnetic sphincter and intrasphincteric injections are promising options but under evaluation. Finally, stoma remains an option after failure of different strategies.
- A case report of an intramedullary cervical teratoma in an adult patient with cervical spondylotic radiculopathy. [Journal Article]
- NNeurocirugia (Astur) 2018 Oct 25
- Spinal cord teratomas are rare. There are few reports of teratomas affecting the cervical spine and their association with spondylotic radiculopathy has not been described. A 59-year-old woman with h...
Spinal cord teratomas are rare. There are few reports of teratomas affecting the cervical spine and their association with spondylotic radiculopathy has not been described. A 59-year-old woman with history of fecal incontinence attended with cervical radicular pain radiating to upper limbs. Physical examination showed distal muscle hypotrophy and abolishment of bicipital, tricipital, and brachioradialis reflexes of the right arm, preserving proximal strength. Also, hiporreflexia and loss of proprioception in the right lower limb was observed. Magnetic resonance imaging showed an intramedullary mass at C7-T1, accompanied by intervertebral disk protrusions and dural sac compressions at the same level. One-stage posterior-anterior operative approach for tumor resection, decompression of the radiculopathy and replacement of intervertebral discs was performed. The histopathological diagnosis was for a mature teratoma. We described the first case of an intramedullary cervical teratoma associated with radiculopathy in an adult, providing evidence of rare long-lasting teratomas affecting the cervical spine.
- Burden and outcomes for complex perianal fistulas in Crohn's disease: Systematic review. [Journal Article]
- WJWorld J Gastroenterol 2018 Nov 14; 24(42):4821-4834
- CONCLUSIONS: Complex perianal fistulas in CD pose substantial clinical and humanistic burden. There is a need for effective treatments, especially for patients refractory to anti-tumour necrosis factor-α agents, as evidenced by high failure and relapse rates.
- Pubovisceral muscle and anal sphincter defects in women with fecal or urinary incontinence after vaginal delivery. [Journal Article]
- TCTech Coloproctol 2018 Nov 26
- CONCLUSIONS: The study data demonstrate that half of the women had combined defects of PVM and sphincter. There were correlations between anatomical abnormalities including the anal sphincter and/or pubovisceral muscle defects with decrease in the anal pressures and increased severity of FI.
- Different routes of heroin intake cause various heroin-induced leukoencephalopathies. [Journal Article]
- JNJ Neurol 2018 Nov 26
- CONCLUSIONS: These data could help physicians make an early diagnosis and predict prognosis and suggest that prompt antioxidative or symptomatic treatments might reduce the long-term consequences and mortality of heroin-induced leukoencephalopathy.
- Treatment Outcome of Acute Sacral Nerve Stimulation in Functional Anorectal Pain. [Journal Article]
- PPPain Pract 2018 Nov 25
- CONCLUSIONS: The effect of SNS in treating FAP was positive, and the improvement of symptoms was substantial and worthy of clinical promotion. This article is protected by copyright. All rights reserved.
- A systematic review of non-invasive modalities used to identify women with anal incontinence symptoms after childbirth. [Review]
- IUInt Urogynecol J 2018 Nov 23
- CONCLUSIONS: This systematic review confirms that questionnaires can be used effectively after childbirth to identify women with anal incontinence. Given the methodological limitations associated with non-validated questionnaires, assessing all women following childbirth for pelvic-floor symptomatology, including anal incontinence, using validated questionnaires should be considered.
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- Gut-Directed Pelvic Floor Behavioral Treatment for Fecal Incontinence and Constipation in Patients with Inflammatory Bowel Disease. [Journal Article]
- IBInflamm Bowel Dis 2018 Nov 19
- CONCLUSIONS: Behavioral treatment effectively improves functional gut symptoms in a large majority of patients who are in IBD disease remission and who have not responded to drug therapy. 10.1093/ibd/izy344_video1izy344.video15968879349001.