Diagnosis and Management of Fecal Incontinence at a Specialty Outpatient Clinic

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  • 便失禁専門外来の試み

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Abstract

Fecal incontinence (FI) is a disabling disease that may have devastating psycho-social consequences. FI patients do not seek medical advice because of embarrassment and low expectations of medical care, and so they are unaware of available treatments. Therefore, we opened an FI specialty outpatient clinic in March 2005. Two hundred and fifty patients with FI have consulted our specialty outpatient clinic as of December 2006. The median age was 72 and 167 patients (67%) were female. One hundred and eighty-one patients had mainly passive incontinence (PI) and 26 had mainly urge incontinence (UI). The causes of FI identified were: 48 obstetric; 44 idiopathic; 25 rectal prolapse; 21 anal surgical injury; 18 internal anal sphincter degeneration and so on. The majority of other patients could be managed successfully with conservative therapy including pharmacologic treatment (28 cases) such as polycarbophil-calcium, manometry-based biofeedback therapy (42) and electrostimulation in the anal canal (144). Anal sphincteroplasty was performed in only 9 patients. Because most cases of fecal incontinence are amenable to simple and inexpensive treatments, healthcare providers need to establish multiskilled regional centers offering a range of diagnostic and treatment expertise.<br>

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