Urgency and fecal soiling in people with bowel dysfunction

Drossman, Douglas A.; Sandler, Robert S.; Broom, Colin; McKee, Daphne C.

doi:10.1007/bf01296523

Cited by 74 publications

(34 citation statements)

References 8 publications

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“…The threshold of phasic sphincter contraction reverted to normal in the three patients with abnormal values. After retraining, squeeze duration increased significantly from 19-6 (2 4) to 38-3 (3-2) seconds (p<0-0001) with all patients gaining a squeeze duration of at least 20 seconds (Fig 2). At the first interview, 11 patients reported a substantial improvement in faecal continence (good responders according to our criteria).…”

Section: Biofeedback Treatmentmentioning

confidence: 99%

Liquid stool incontinence with severe urgency: anorectal function and effective biofeedback treatment.

Chiarioni

Scattolini

Bonfante

et al. 1993

Gut

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The motor and sensory function of the anorectum is well characterised in patients with solid stool incontinence. Fewer data are available in the case of liquid stool incontinence. Anorectal sensorimotor function was studied in 16 patients with liquid stool incontinence and severe urgency (10 with diarrhoea) unresponsive to conventional medical treatment, and in 16 healthy volunteers. The only significant difference found between incontinent patients and controls was a reduction in squeeze duration (p<00001). Fourteen patients were selected to receive biofeedback treatment. Treatment was associated with a substantial improvement in continence in 12 patients and with a significant decrease in urgency (p<005). Bowel frequency was not significantly influenced. Most patients showed a persistent improvement in anal motor function. Functional parameters were not predictive of outcome of treatment; the poor responders showed major psychological problems. In conclusion, an anal motor deficit is often present in disabling liquid stool incontinence. Biofeedback may improve anal continence in 75% of patients.

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Section: Biofeedback Treatmentmentioning

confidence: 99%

Liquid stool incontinence with severe urgency: anorectal function and effective biofeedback treatment.

Chiarioni

Scattolini

Bonfante

et al. 1993

Gut

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“…People with mild fecal loss such as staining are unwilling to admit to themselves that they have an FI problem [9] . As the problem worsens and patients inevitably accept that they have FI, they are reluctant to disclose the problem to others [9][10][11][12][13][14][15] , with only 5%-27% seeking help from their doctors [15] . Lack of disclosure may be to the result of embarrassment, the erroneous belief that FI is a normal part of aging, or the perception that no treatment is available.…”

Section: Introductionmentioning

confidence: 99%

Impact of fecal incontinence on quality of life

Bartlett¹,

Nowak²,

Ho³

2009

WJG

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AIM:To explore the impact of fecal incontinence (FI) on quality of life (QOL) of patients attending urogynecology and colorectal clinics (CCs). METHODS:Cross-sectional study of 154 patients (27 male) with FI, who attended the clinics at a regional hospital in North Queensland, Australia in 2003 and2004, and completed the Fecal Incontinence Quality of Life Scale (FIQL: 1 = very affected; 4 = not affected). RESULTS:More than 22% of patients had their QOL affected severely by FI. Patients reported that they had not previously been asked about FI by a medical practitioner nor did they voluntarily disclose its presence. The median FIQL scores for all participants were: lifestyle = 3.24; coping = 2.23; depression = 2.42; and embarrassment = 2.33. Increasing frequency of soiling had a negative effect on all four FIQL scales (P < 0.001) as did the quantity of soiling (P < 0.01). Female CC patients had poorer FIQL scores than urogynecology clinic patients for lifestyle (P = 0.015), coping (P = 0.004) and embarrassment (P = 0.009), but not depression (P = 0.062), despite having experienced FI for a shorter period. CONCLUSION:Failure to seek treatment for FI degrades the quality of patients' lives over time. FI assessment tools should incorporate the quantity of fecal loss.

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“…Although those seeing doctors appear over anxious, the apparent relationship between anxiety and symptoms may be an artefact of selective self referral as non-anxious individuals with similar symptoms may never consult a doctor. 3 The precise role of anxiety is thus uncertain and as only half of IBS patients are overtly anxious, it is clear that there must be other causes. Recent surveys have indicated that, depending on the country and whether they are in primary or secondary care, 6-17% of unselected IBS patients report that their IBS began with a bout of gastroenteritis.…”

mentioning

confidence: 99%

Prognosis in post-infective irritable bowel syndrome: a six year follow up study

Neal

Barker²,

Spiller³

2002

Gut

230

155

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Background: Irritable bowel syndrome developing following infective gastroenteritis accounts for approximately 1 in 10 of unselected IBS patients. Aims: To define the long term natural history of post-infective IBS (PI-IBS). Methods: A total of 436 individuals, who had previously responded to a questionnaire on their bowel habits following an acute episode of gastroenteritis, were sent a questionnaire about their current bowel habits and physical and mental health six years after their initial illness. Results: Complete data on original bowel habit, episodes of gastroenteritis, mental health history, and subsequent bowel habit at six years were obtained in 192 individuals. Of these, there were 14 cases of "post-infective IBS" (PI-IBS) and 13 who had IBS prior to infection (previous IBS). Over the six year follow up period there were 20 "new non-infective IBS cases" (new IBS). The strongest risk factor for developing any type of IBS was female sex (relative risk 2.2, p<0.05). Compared with new IBS, those with PI-IBS had significantly more days with loose stools (p<0.05) but a similar number of days with pain, urgency, and bloating. Six of 14 (43%) PI-IBS and four of 13 (31%) previous IBS patients recovered by six years (NS). Of 27 IBS patients followed for six years, only 1/8 with a history of anxiety or depression recovered compared with 9/19 without such a history (p=0.19). Conclusion: PI-IBS differs from non-infective IBS by having more diarrhoeal features. Less than half of both PI-IBS and non-infective IBS cases recover over six years. A history of anxiety and depression severe enough to warrant treatment may impair recovery but larger numbers are needed to prove this.

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Urgency and fecal soiling in people with bowel dysfunction

Cited by 74 publications

References 8 publications

Liquid stool incontinence with severe urgency: anorectal function and effective biofeedback treatment.

Liquid stool incontinence with severe urgency: anorectal function and effective biofeedback treatment.

Impact of fecal incontinence on quality of life

Prognosis in post-infective irritable bowel syndrome: a six year follow up study

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