Περίληψη:
Fecal incontinence is a devastating disability, and although this
condition is widely accepted as a problem in the elderly, it is now
becoming apparent that much younger age groups are also frequently
affected. Thorough assessment of anorectal incontinence is very
important to choosing the most appropriate treatment. Careful
history-taking and physical examination can identify the cause of most
cases of incontinence and are essential in every patient. Several
incontinence scoring systems have been proposed to provide an objective
measure of a subject’s degree of fecal incontinence, but only one
acknowledges the important contribution of the severity of symptoms to
quality of life. The investigations used to evaluate anorectal
physiology include anorectal manometry, anal endosonography, nerve
stimulation techniques, electromyography, defecography, endoluminal
magnetic resonance imaging, the saline continence test, and the
balloon-retaining test. Although all of these tests are important, the
most useful for patients with incontinence are anal manometry, anal
endosonography, and the pudendal nerve terminal motor latency test,
because they can identify anatomic or physiologic abnormalities for
which there may be effective treatments.
