Risk of anal incontinence in women with inflammatory bowel diseases after delivery

Koželuhová, Jana; J, Kotyza; Balihar, Karel; Krčma, Michal; Čedíková, Miroslava; Karbanová, Jaroslava; Kališ, Vladimír; Janská, Eva; Matějovič, Martin

doi:10.4149/bll_2017_072a

Cited by 5 publications

(8 citation statements)

References 26 publications

(46 reference statements)

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“…In 17 trials (77.3%) 8,356,358,359,361–365,369–376 FI was evaluated using specific questionnaires. Ten different tools were adopted.…”

Section: Resultsmentioning

confidence: 99%

“…366,367 However, no additional data were specified regarding diagnostic evaluation. In 15 studies (68.2%) the diagnosis of FI was obtained only with one technique (questionnaires in 12 studies 8,358,359,361,369–376 and anal manometry in three studies). 357,360,368 In three trials (13.6%) 365–367 two techniques were used, while in four papers (18.2%) 356,362–364 more than three methods were combined.…”

Section: Resultsmentioning

confidence: 99%

“…Ten different tools were adopted. The Wexner score, the Vaizey score and the inflammatory bowel disease quality of life (IBDQ) questionnaire were the most frequently used tools (in five (22.7%), 356 , 369 , 371 , 373 , 376 five (22.7%) 361 , 362 , 369 , 370 , 372 and four (18.2%) 8 , 356 , 362 , 370 studies, respectively). In two studies (9.1%) 359,363 non‐validated questionnaires were applied.…”

Section: Resultsmentioning

confidence: 99%

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Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

et al. 2020

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Background Fecal incontinence is a disabling condition affecting up to 20% of women. Objective We investigated fecal incontinence assessment in both inflammatory bowel disease and non-inflammatory bowel disease patients to propose a diagnostic approach for inflammatory bowel disease trials. Methods We searched on Pubmed, Embase and Cochrane Library for all studies on adult inflammatory bowel disease and non-inflammatory bowel disease patients reporting data on fecal incontinence assessment from January 2009 to December 2019. Results In total, 328 studies were included; 306 studies enrolled non-inflammatory bowel disease patients and 22 studies enrolled inflammatory bowel disease patients. In non-inflammatory bowel disease trials the most used tools were the Wexner score, fecal incontinence quality of life questionnaire, Vaizey score and fecal incontinence severity index (in 187, 91, 62 and 33 studies). Anal manometry was adopted in 41.2% and endoanal ultrasonography in 34.0% of the studies. In 142 studies (46.4%) fecal incontinence evaluation was performed with a single instrument, while in 64 (20.9%) and 100 (32.7%) studies two or more instruments were used. In inflammatory bowel disease studies the Wexner score, Vaizey score and inflammatory bowel disease quality of life questionnaire were the most commonly adopted tools (in five (22.7%), five (22.7%) and four (18.2%) studies). Anal manometry and endoanal ultrasonography were performed in 45.4% and 18.2% of the studies. Conclusion Based on prior validation and experience, we propose to use the Wexner score as the first step for fecal incontinence assessment in inflammatory bowel disease trials. Anal manometry and/or endoanal ultrasonography should be taken into account in the case of positive questionnaires.

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“…In 17 trials (77.3%) 8,356,358,359,361–365,369–376 FI was evaluated using specific questionnaires. Ten different tools were adopted.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

et al. 2020

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“…In this study, the only significant modifiable risk factor for UI was BMI; this result was consistent with an earlier finding (17). In fact, weight control represents a protective factor against developing post-delivery incontinence disorder in high-risk women (e.g., those suffering from inflammatory bowel disease) (24, 25).…”

Section: Discussionmentioning

confidence: 99%

Fecal and Urinary Incontinence Associated with Pregnancy and Childbirth

et al. 2019

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Introduction:Fecal incontinence (FI) and urinary incontinence (UI) are major problems faced by women worldwide, with pregnancy and delivery representing two major risk factors for these conditions. The prevalence of FI and UI varies across studies. In our region, only a few publications have addressed this topic.Aim:The aim of this study was to determine the prevalence of FI and UI in Saudi pregnant women, their characteristics, and a specific clinical pattern that could identify patients that are at a risk for incontinence.Materials and Methods:This was a questionnaire-based crosssectional study conducted over a 3 months period in 2017, among pregnant women attending King Abdulaziz University Hospital, Jeddah, Saudi Arabia.Results:Our study included 393 pregnant women. FI was reported by 24 patients (6.1%), and fecal urgency was reported by 30.5%. UI was reported by 84 patients (21.4 %). When patients with no UI were compared with patients with UI, the only statistically significant factor was BMI (p = 0.043). There were no statistically significant differences when comparing patients with FI versus no-FI, and fecal urgency versus no-fecal urgency. However, laceration (OR: 1.696, p = 0.036), episiotomy (OR: 1.413, p = 0.029), constipation (OR: 1.944, p < 0.001), hypertension (OR: 1.993, p = 0.022), and Bristol stool scale score (p = 0.002) were statistically significant factors for determining fecal control.Conclusion:FI and UI are frequently associated with pregnancy and delivery, but their prevalence is underestimated. The role of the practitioner is crucial in preventing and treating these conditions, and in impeding their harmful effects on the postpregnancy quality of life of Saudi women.

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“… 146 There is mixed evidence on whether women with IBD have a greater risk of fecal incontinence after NVD compared with NVD in women without IBD. 147 , 148 In the absence of convincing data, delivery decisions for women without a clear indication for CS should be based on obstetric factors.…”

Section: Management Of Ibd During Pregnancymentioning

confidence: 99%

Review of pregnancy in Crohn’s disease and ulcerative colitis

Laube

Paramsothy

Leong

2021

Therap Adv Gastroenterol

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Inflammatory bowel disease (IBD) frequently affects women of childbearing age and can have implications in pregnancy. Most women with IBD have comparable fertility with women in the general population. Fertility is reduced in women with active disease or previous ileal-pouch–anal anastomosis (IPAA) surgery and is temporarily reduced in men taking sulfasalazine. Women with IBD have an increased risk of preterm delivery, low birth weight, small-for-gestational-age infants and Cesarean section (CS) delivery, however, no increased risk of congenital abnormalities. These adverse outcomes are particularly prevalent for women with active IBD compared with those with quiescent disease. Conception should occur during disease remission to optimize maternal and fetal outcomes and reduce the risk of disease exacerbations during pregnancy. Pre-conception counseling is therefore pertinent to provide patient education, medication review for risk of teratogenicity and objective disease assessment. Most medications are safe during pregnancy and breastfeeding, with the exception of methotrexate, ciclosporin, allopurinol and tofacitinib. Delivery modality should be guided by obstetric factors in most cases; however, CS is recommended for women with active perianal disease and can be considered for women with inactive perianal disease or IPAA. In conclusion, most women with IBD have uncomplicated pregnancies. Active IBD is the predominant predictor of poor outcomes and disease exacerbations; therefore, maintenance of disease remission during and before pregnancy is crucial.

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Risk of anal incontinence in women with inflammatory bowel diseases after delivery

Cited by 5 publications

References 26 publications

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

Fecal and Urinary Incontinence Associated with Pregnancy and Childbirth

Review of pregnancy in Crohn’s disease and ulcerative colitis

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