FECAL INCONTINENCE - 03/09/11

Doi : 10.1016/S0889-8553(05)70170-9

Mark J. Cheetham, BSc, FRCS ^a, Andrew J. Malouf, FRACS ^a, Michael A. Kamm, MD, FRCP, FRACP ^a,^b
^a Departments of Physiology (MJC, AJM, MAK)
^b Gastroenterology (MAK), St Mark's Hospital, London, United Kingdom

Résumé

The ability to store feces until a socially acceptable time and to void under conscious control is a fundamental social and physiologic process. Loss of the mechanisms controlling fecal continence can be devastating, resulting in social isolation and reduced quality of life.^{45Sailer M., Bussen D., Debus E.S., et al. Quality of life in patients with benign anorectal disorders Br J Surg 1998 ; 85 : 1716-1719 [cross-ref]

Cliquez ici pour aller à la section Références} Estimates of the incidence of fecal incontinence vary greatly according to the clinical setting. In an elderly self-caring population, 7% of healthy people aged greater than 65 years had fecal incontinence at least weekly.^{58Talley N.J., O'Keefe E.A., Zinsmeister A.R., et al. Prevalence of gastrointestinal symptoms in the elderly: A population-based study Gastroenterology 1992 ; 102 : 895-901 [cross-ref]

Cliquez ici pour aller à la section Références} Of elderly people in residential care, 46% suffer from fecal incontinence.^{40Nelson R., Furner S., Jesudason V. Fecal incontinence in Wisconsin nursing homes: Prevalence and associations Dis Colon Rectum 1998 ; 41 : 1226-1229 [cross-ref]

Cliquez ici pour aller à la section Références} There is a strong association with urinary incontinence, with fecal incontinence reported by 26% of women attending a urogynecology clinic.^{25Khullar V., Damiano R., Toozs-Hobson P., et al. Prevalence of faecal incontinence among women with urinary incontinence Br J Obstet Gynaecol 1998 ; 105 : 1211-1213 [cross-ref]

Cliquez ici pour aller à la section Références} Only a few patients suffering from fecal incontinence present to health care professionals, however. Embarrassment and social stigma often delay presentation by several years. Detailed assessment and a multidisciplinary approach to management are essential for therapy to be successful.