Study of the prevalence and management of patients with faecal incontinence in Old People's Homes

Thomas, Thelma M.; Ruff, Coralease C.; Karran, Olive; Mellows, Sandra; Meade, T. W.

doi:10.1093/oxfordjournals.pubmed.a043932

Cited by 14 publications

(15 citation statements)

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“…Faecal incontinence is a very unpleasant and debilitating symptom which occurs predominantly in postmenopausal women. The sex ratio shows a female to male preponderance of 8:1, and most affected women are parous 1 . While faecal incontinence may occur following obstetric trauma 2,3 , in the majority of sufferers symptoms become manifest after the menopause, probably because of the effects of ageing and the hypo‐oestrogenic status of the nerves, muscles and ligaments of the pelvis and of the anorectal supporting tissues.…”

Section: Introductionmentioning

confidence: 99%

The influence of oestrogen replacement on faecal incontinence in postmenopausal women

Donnelly

O'Connell

O’Herlihy

1997

BJOG

116

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Objective To assess the value of hormone replacement therapy (HRT) in postmenopausal women with faecal incontinence.Design Prospective observational study using a bowel function questionnaire and anorectal physiological testing before and after six months of standard oestrogen hormone replacement therapy.Setting Menopause and colorectal clinics of two university teaching hospitals.Participants Twenty postmenopausal women (mean age 61 years) with demonstrable faecal incontinence (mean duration 6.1 years) previously untreated with HRT.Main outcome measures Improvement in symptoms and objective alteration in anorectal physiology tests.Results All women had significant symptoms of anorectal dysfunction before treatment, whereas 5/20 (25%) were asymptomatic after six months of HRT, and a further 13/20 (65%) were symptomatically improved in terms of flatus control, urgency, and faecal staining. There was no change in bowel fiequency or stool consistency following HRT, but social activity was considerably improved. Anal resting pressures and voluntary squeeze increments were significantly increased following oestrogen therapy, although no differences in anal canal vector symmetry index were observed. Insignificant changes occurred in threshold volume of rectal sensation and volume of defaecatory urge, but there was a significant change in maximum tolerated rectal volume after six months. Neither anal canal electrosensitivity nor pudendal nerve terminal motor latency was altered following HRT. Seven of the 20 women (35%) had an identifiable anal sphincter defect on anal endosonography. Statistical analysis, however, showed no significant difference in outcome in this group compared with those with an intact anal sphincter. A larger population sample may demonstrate this. ConclusionThis observational study has shown a possible benefit of oestrogen replacement in postmenopausal women with symptoms of impaired faecal continence. A prospective randomised controlled trial is now advisable to test this hypothesis.

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Section: Introductionmentioning

confidence: 99%

The influence of oestrogen replacement on faecal incontinence in postmenopausal women

Donnelly

O'Connell

O’Herlihy

1997

BJOG

116

View full text Add to dashboard Cite

show abstract

“…2 Attempts to quantify community prevalence have been hampered by poor response rates and inappropriate data-collection methods. In addition, many studies have focused on the prevalence of fecal incontinence in specific populations, most notably the institutionalized elderly [3][4][5][6][7][8] and postpartum females. [9][10][11][12][13][14][15][16][17][18][19][20] Fecal incontinence is commonly defined as a loss of voluntary control of the passage of liquid or solid stool.…”

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confidence: 99%