Clinical assessment of the anal continence plug

Christiansen, John; Roed-Petersen, K

doi:10.1007/bf02048363

Cited by 34 publications

(19 citation statements)

References 8 publications

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“…Little information is found in the literature about the use of anal plugs [4,[13][14][15][16][17][18] . A Cochrane review from 2005 [4] looking at randomized and quasi-randomized controlled trials only found four studies, from which only two were published [13,14] .…”

Section: Discussionmentioning

confidence: 99%

Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation

Cazemier¹,

Felt‐Bersma²,

Mulder³

2007

WJG

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AIM:To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation (RCI) in patients with fecal incontinence or constipation. METHODS:Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire. RESULTS:Of the 201 patients (93 adults, 108 children), 101 (50%) responded. Adults: anal plugs (8), five stopped immediately, one stopped after 20 mo and two used it for 12-15 mo. RCI (40, 28 fecal incontinence, 12 constipation), 63% are still using it (mean 8.5 years), 88% was satisfied. Younger adults (< 40 years) were more satisfied with RCI (94 % vs 65%, P = 0.05).Children: anal plugs (7), 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI (26 fecal incontinence, 22 constipation), 90% are still using it (mean time 6.8 years) and felt satisfied. Children tend to be more satisfied (P = 0.001). Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation. CONCLUSION:RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.

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Section: Discussionmentioning

confidence: 99%

Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation

Cazemier¹,

Felt‐Bersma²,

Mulder³

2007

WJG

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“…This device is attached to the perineum using a tape and can be easily retrieved. Unfortunately, many patients are unable to tolerate a prolonged insertion of this device, owing to many factors (181,182). It may be useful for patients with impaired anal canal sensation, those with neurological disease (183), and those who are institutionalized or immobilized.…”

Section: Specific Treatmentmentioning

confidence: 99%

Diagnosis and Management of Fecal Incontinence

Rao

2004

Am J Gastroenterology

284

295

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DEFINITIONFecal incontinence is defined as either the involuntary passage or the inability to control the discharge of fecal matter through the anus. Clinically there are three subtypes (a) passive incontinence-the involuntary discharge of stool or gas without awareness; (b) urge incontinence-the discharge of fecal matter in spite of active attempts to retain bowel contents, and (c) fecal seepage-the leakage of stool following otherwise normal evacuation. The severity of incontinence can range from the unintentional elimination of flatus to the seepage of liquid fecal matter or sometimes the complete evacuation of bowel contents. Not surprisingly, these events cause considerable embarrassment, which in turn can lead to a loss of self-esteem, social isolation, and a diminished quality of life (1). EPIDEMIOLOGYAlthough fecal incontinence affects people of all ages, its prevalence is disproportionally higher in women, in the elderly, and in nursing home residents. Estimates of its prevalence vary greatly and depend on the clinical setting, the influence of social stigma, the definition of incontinence, and the frequency of occurrence.In the U.S. householder survey, frequent leakage of stool or fecal staining for more than 1 month was reported by 7.1% and 0.7% of the population, respectively (2). In contrast, two or more episodes of fecal incontinence per month were reported by 0.8% of patients presenting to primary care clinics in the UK (3). In an elderly (>65 yr) self-caring population, fecal incontinence occurred at least once a week in 3.7% of subjects and in more men than women (men:women = 1.5:1) (4). In contrast, 25-35% of institutionalized patients (5) and 10-25% of hospitalized geriatric patients (6) suffer from fecal incontinence. In the United States, fecal incontinence is the second leading cause for placement in nursing homes (6).In a survey of 2,570 households, comprising 6,959 individuals, the prevalence of at least one episode of incontinence during the previous year was 2.2%; among these 63% were women, 30% were >65 yr of age, 36% were incontinent of solid stool, 54% of liquid stool, and 60% of flatus (7). Furthermore, in another prospective survey of patients attending either a gastroenterology or a primary care clinic, over 18% reported fecal incontinence at least once a week (8). Only one third had ever discussed the problem with a physician (8). When stratified for the frequency of episodes, 2.7% of patients reported daily incontinence, 4.5% weekly, and 7.1% once per month (8). In another survey, fecal incontinence was associated with urinary incontinence in 26% of women attending a Uro/Gyn Clinic (9). A higher incidence of mixed fecal and urinary incontinence was also reported in nursing home residents (10, 11).The cost of health care related to fecal incontinence includes items that can be measured such as the evaluation, diagnosis and treatment of incontinence, medications, the use of disposable pads and other ancillary devices, skin care, and nursing care. Approximately $400 million/year we...

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“…68 No correlation was found between the results of anorectal physiology studies and the benefit or inconvenience of using the plug. 69 A trial of the anal plug in patients quickly reveals whether the patient will find it an effective and acceptable option. 70 …”

Section: Contributing Factorsmentioning

confidence: 99%