Service de Gastroentérologie, Hôpital Nord, AP-HM, Interface de recherche translationnelle en neurogastroentérologie, CRN2M, UMR 7286, Aix-Marseille Université, Marseille, France.
Colorectal Dis. 2014 Mar;16(3):159-66. doi: 10.1111/codi.12410.
Faecal incontinence is common and significantly affects quality of life. Its treatment involves dietary manipulation, medical treatments, perineal rehabilitation or surgery. In this paper, the French National Society of Coloproctology offers recommendations based on the data in the current literature, including those on recently developed treatments. There is a lack of high quality data and most of the recommendations are therefore based either on grade of recommendation B or expert recommendation (Level 4). However, the literature supports the construction of an algorithm based on the available scientific evidence and expert recommendation which may be useful in clinical practice. The French National Society of Coloproctology proposes a decision-making algorithm that includes recent developments of treatment. The current recommendations support sacral nerve modulation as the key treatment for faecal incontinence. They do not support the use of sphincter substitutions except in certain circumstances. Transanal irrigation is a novel often successful treatment of faecal incontinence due to neurological disorders.
粪便失禁很常见,严重影响生活质量。其治疗包括饮食调整、药物治疗、会阴康复或手术。本文法国国家肛肠学会根据现有文献中的数据提供了建议,包括最近开发的治疗方法。高质量数据的缺乏使得大多数建议都基于推荐级别 B 或专家建议(第 4 级)。然而,文献支持根据现有科学证据和专家建议构建算法,这在临床实践中可能是有用的。法国国家肛肠学会提出了一个决策算法,其中包括治疗的最新进展。目前的建议支持骶神经调节作为粪便失禁的主要治疗方法。除了在某些情况下,不支持使用括约肌替代物。经肛门灌洗是一种新颖的、通常有效的治疗神经源性粪便失禁的方法。