Rectal Hyposensitivity

Burgell, Rebecca; Scott, S. M.

doi:10.5056/jnm.2012.18.4.373

Cited by 64 publications

(67 citation statements)

References 129 publications

(186 reference statements)

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“…Moreover, it has been suggested that prevalence data may be distorted by men being more unwilling to report fecal incontinence than women. 4,8 Fecal continence is a complex physiological function that involves anatomical and functional integrity of the anal sphincter, anal and rectal sensitivity and intrinsic and extrinsic motor innervation 16 ; fecal consistency also plays a role, given that loose and liquid stools are less easily retained. Fecal incontinence is regarded as a multifactorial condition as it is not usually associated with just one pathogenic abnormality.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life Differences in Female and Male Patients with Fecal Incontinence

Mundet

Ribas

Arco

et al. 2015

J Neurogastroenterol Motil

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Background/AimsTo explore and compare quality of life (QoL) differences in female and male patients with fecal incontinence. MethodsNinety-one patients with fecal incontinence (60 women, mean (SD) age 64.13 (9.72) years; 31 men, mean (SD) age 63.61 (13.33) years) were assessed for pathophysiology (anorectal manometry and ultrasound), clinical severity (Wexner and Vaizey scales), QoL (Fecal Incontinence Quality of Life Score [FIQL]) and health status (EQ-5D). ResultsExternal and internal anal sphincter impairment rates were 96.5% and 70.2%, respectively, in women, compared to 30% and 43.3% respectively in men (P < 0.05). Clinical severity was similar in both sexes, with mean (SD) Wexner scores of 10.95 (4.35) for women and 9.81 (4.30) for men, and mean (SD) Vaizey scores of 13.27 (4.66) for women and 11.90 (5.22) for men. Scores for women were significantly lower for all FIQL depression and coping subscales (P < 0.001) and the EQ-5D depression subscale (P < 0.01). EQ-5D index was 0.687 (0.20) for women and 0.835 (0.15) for men (P < 0.001). QoL was negatively affected by female gender (-1.336), anxiety/depression (-1.324) and clinical severity (-0.302), whereas age had a positive impact (0.055 per year) (P < 0.01). ConclusionsThe pathophysiology of fecal incontinence differed between the sexes. For similar severity scores, impact on QoL was higher in women. Gender had the highest impact on QoL compared to other factors. QoL measurements should be part of assessment and treatment protocols.

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Section: Introductionmentioning

confidence: 99%

Quality of Life Differences in Female and Male Patients with Fecal Incontinence

Mundet

Ribas

Arco

et al. 2015

J Neurogastroenterol Motil

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“…While rectal hyposensitivity is often present in constipation (Scott et al, 2011) and regularly in spinal cord injury (Burgell and Scott, 2012), both rectal hypo-and hypersensitivity can be present in irritable bowel syndrome (Mertz et al, 1995). Faecal incontinence patients can present with rectal and anal hyper-or hyposensitivity (Chan et al, 2005;Vasudevan et al, 2007;Burgell and Scott, 2012).…”

Section: Discussionmentioning

confidence: 98%

“…Faecal incontinence patients can present with rectal and anal hyper-or hyposensitivity (Chan et al, 2005;Vasudevan et al, 2007;Burgell and Scott, 2012). As in some conditions both hypo-and hypersensitivity may be present, abnormal sensation is often tied to more severe symptoms and affects treatment options, sensitivity testing is an important part of patient evaluation (Burgell and Scott, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…The rectum and anus are richly innervated with mucosal receptors sensitive to temperature, pressure and stretch (Duthie and Gairns, 1960) disorders of anorectal sensation are associated with a number of functional bowel problems such as faecal incontinence, chronic constipation and irritable bowel syndrome (Mertz et al, 1995;Chan et al, 2005;Vasudevan et al, 2007;Scott et al, 2011;Burgell and Scott, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Mechanically evoked cortical potentials: A physiological approach to assessment of anorectal sensory pathways

Carrington

Evers

Scott

et al. 2015

Journal of Neuroscience Methods

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“…The crucial pathophysiological difference may well lie in different visceral sensitivities: colonic hypersensitivity is more common in IBS, and rectal hyposensitivity is more often seen in FC (17)(18)(19).…”

Section: What Similarities and Differences Are There Between Irritablmentioning

confidence: 99%

Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult

Mearin¹,

Ciriza²,

Mínguez³

et al. 2016

Rev Esp Enferm Dig

104

151

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In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants). Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antidepressants, psychological therapy, acupuncture, enemas, sacral root neurostimulation, surgery) are discussed, and practical recommendations are made regarding each of them.

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Rectal Hyposensitivity

Cited by 64 publications

References 129 publications

Quality of Life Differences in Female and Male Patients with Fecal Incontinence

Quality of Life Differences in Female and Male Patients with Fecal Incontinence

Mechanically evoked cortical potentials: A physiological approach to assessment of anorectal sensory pathways

Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult

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