Clinical and instrumental parameters in patients with constipation and incontinence: their potential implications in the functional aspects of these disorders

Brusciano, Luigi; Limongelli, Paolo; Genio, Gianmattia del; Rossetti, Gianluca; Sansone, S.; Healey, Adrienne; Maffettone, V.; Napolitano, Vincenzo; Pizza, Francesco; Tolone, Salvatore; Genio, A. Del

doi:10.1007/s00384-009-0678-2

Cited by 36 publications

(29 citation statements)

References 33 publications

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“…Overall, 63 studies published between 1984 and 2017 contributed to the systematic review, providing data on the diagnostic yield of 7519 barium defecographies (range, 40‐896 per study) and 668 MRIDs (range, 40‐188 per study) in patients with CC, and 225 barium defecographies (range, 8‐47 per study) and 50 MRIDs (n = 1 study) in HV (Table ). Overall, only 9 (14%) studies were controlled using either healthy (n = 2) or nonhealthy (n = 3; eg, patients presenting for investigation of other complaints) volunteers, or a combination of both subjects (n = 4) …”

Section: Summary Of Search Results and Study Qualitymentioning

confidence: 99%

“…Among the 59 studies in patients with CC, diagnostic criteria and prevalence of functional abnormalities were provided in 42 (71%), based on either (a) (n = 22); (b) (n = 2); (c) (n = 2); (a + b) (n = 4); (a + c) (n = 7); (b + c) (n = 1); or (a + b+c) (n = 4) . Quantitative meta‐analysis of these studies, including four comparative (barium defecography vs MRID) studies, showed a pooled prevalence of 24.1% (95% CI, 20.2‐28.4) on barium defecography and 25.9 (14.1‐39.6) on MRID (Figure S6).…”

Section: Summary Of Search Results and Study Qualitymentioning

confidence: 99%

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Systematic review with meta‐analysis: defecography should be a first‐line diagnostic modality in patients with refractory constipation

Grossi

Tanna

Heinrich

et al. 2018

Aliment Pharmacol Ther

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Summary Background Defecography is considered the reference standard for the assessment of pelvic floor anatomy and function in patients with a refractory evacuation disorder. However, the overlap of radiologically significant findings seen in patients with chronic constipation (CC) and healthy volunteers is poorly defined. Aim To systematically review rates of structural and functional abnormalities diagnosed by barium defecography and/or magnetic resonance imaging defecography (MRID) in patients with symptoms of CC and in healthy volunteers. Methods Electronic searches of major databases were performed without date restrictions. Results From a total of 1760 records identified, 175 full‐text articles were assessed for eligibility. 63 studies were included providing data on outcomes of 7519 barium defecographies and 668 MRIDs in patients with CC, and 225 barium defecographies and 50 MRIDs in healthy volunteers. Pathological high‐grade (Oxford III and IV) intussuscepta and large (>4 cm) rectoceles were diagnosed in 23.7% (95% CI: 16.8‐31.4) and 15.9% (10.4‐22.2) of patients, respectively. Enterocele and perineal descent were observed in 16.8% (12.7‐21.4) and 44.4% (36.2‐52.7) of patients, respectively. Barium defecography detected more intussuscepta than MRID (OR: 1.52 [1.12‐2.14]; P = 0.009]). Normative data for both barium defecography and MRID structural and functional parameters were limited, particularly for MRID (only one eligible study). Conclusions Pathological structural abnormalities, as well as functional abnormalities, are common in patients with chronic constipation. Since structural abnormalities cannot be evaluated using nonimaging test modalities (balloon expulsion and anorectal manometry), defecography should be considered the first‐line diagnostic test if resources allow.

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Section: Summary Of Search Results and Study Qualitymentioning

confidence: 99%

Section: Summary Of Search Results and Study Qualitymentioning

confidence: 99%

Systematic review with meta‐analysis: defecography should be a first‐line diagnostic modality in patients with refractory constipation

Grossi

Tanna

Heinrich

et al. 2018

Aliment Pharmacol Ther

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“…Four studies evaluated concurrent positivity of US and ARM. These were conducted by three groups, all in surgical departments, one in Brazil and two in Europe and included a total of 279 patients. Concurrent positivity for US among those with positive ARM ranged from 68.4% to 88.6% and the median prevalence of combined positivity (positive on both tests) was 37.6% (range 9.3–46.4).…”

Section: Resultsmentioning

confidence: 99%

Diagnostic testing for dyssynergic defecation in chronic constipation: meta‐analysis

Videlock

Lembo

Cremonini

2013

Neurogastroenterology Motil

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“…However, we did consider anal sphincter operation as a criteria to be assigned to the comorbidity subgroup. Furthermore, as demonstrated by Brusciano and others, it would be interesting to add clinical-functional measurements to demonstrate the underlying factors of FI in a follow-up study [22, 23]. …”

Section: Discussionmentioning

confidence: 99%

Subtypes and symptoms of fecal incontinence in the Dutch population: a cross-sectional study

Meegdenburg

Meinds

Trzpis

et al. 2018

Int J Colorectal Dis

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PurposeTo study the distribution of subtypes and symptoms of fecal incontinence in the general Dutch population.MethodsWe performed a cross-sectional study in a representative sample of the general Dutch population. All respondents (N = 1259) completed the Groningen Defecation and Fecal Continence questionnaire. We assigned the respondents to a so-called healthy subgroup (n = 1008) and a comorbidity subgroup (n = 251). The latter subgroup comprised the respondents who reportedly suffered from chronic diseases and who had undergone surgery known to influence fecal continence. We defined fecal incontinence according to the Rome IV criteria.ResultsThe combination of urge fecal incontinence and soiling was the most frequent form of fecal incontinence in the total study group, the “healthy” subgroup, and the comorbidity subgroup (49.0, 47.3, and 51.5%). Passive fecal incontinence was the least frequent form of fecal incontinence in all three groups (4.0, 5.4, and 2.2%). The prevalence and severity of fecal incontinence was significantly higher in the comorbidity subgroup than in the “healthy” subgroup. Only in the comorbidity subgroup did the fecally incontinent respondents feel urge sensation significantly less often before defecating than their fecally continent counterparts (16.5 versus 48.8%, P < 0.001).ConclusionUrge fecal incontinence combined with soiling is commonest in the general Dutch population. Chronic diseases and bowel and pelvic surgery both increase and aggravate fecal incontinence.Electronic supplementary materialThe online version of this article (10.1007/s00384-018-3051-5) contains supplementary material, which is available to authorized users.

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Clinical and instrumental parameters in patients with constipation and incontinence: their potential implications in the functional aspects of these disorders

Cited by 36 publications

References 33 publications

Systematic review with meta‐analysis: defecography should be a first‐line diagnostic modality in patients with refractory constipation

Systematic review with meta‐analysis: defecography should be a first‐line diagnostic modality in patients with refractory constipation

Diagnostic testing for dyssynergic defecation in chronic constipation: meta‐analysis

Subtypes and symptoms of fecal incontinence in the Dutch population: a cross-sectional study

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