Benezech Alban, Bouvier Michel, Vitton Véronique
Alban Benezech, Michel Bouvier, Véronique Vitton, Service de Gastroentérologie, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, 13915 Marseille, France.
World J Gastrointest Pathophysiol. 2016 Feb 15;7(1):59-71. doi: 10.4291/wjgp.v7.i1.59.
Faecal incontinence (FI) is a disabling and frequent symptom since its prevalence can vary between 5% and 15% of the general population. It has a particular negative impact on quality of life. Many tools are currently available for the treatment of FI, from conservative measures to invasive surgical treatments. The conservative treatment may be dietetic measures, various pharmacological agents, anorectal rehabilitation, posterior tibial nerve stimulation, and transanal irrigation. If needed, patients may have miniinvasive approaches such as sacral nerve modulation or antegrade irrigation. In some cases, a surgical treatment is proposed, mainly external anal sphincter repair. Although these different therapeutic options are available, new techniques are arriving allowing new hopes for the patients. Moreover, most of them are non-invasive such as local application of an α1-adrenoceptor agonist, stem cell injections, rectal injection of botulinum toxin, acupuncture. New more invasive techniques with promising results are also coming such as anal magnetic sphincter and antropylorus transposition. This review reports the main current available treatments of FI and the developing therapeutics tools.
大便失禁(FI)是一种致残且常见的症状,因为其在普通人群中的患病率在5%至15%之间变化。它对生活质量有特别负面的影响。目前有许多工具可用于治疗FI,从保守措施到侵入性手术治疗。保守治疗可能包括饮食措施、各种药物、肛肠康复、胫后神经刺激和经肛门冲洗。如有需要,患者可采用微创方法,如骶神经调节或顺行冲洗。在某些情况下,会建议进行手术治疗,主要是肛门外括约肌修复。尽管有这些不同的治疗选择,但新技术不断涌现,给患者带来了新的希望。此外,它们中的大多数是非侵入性的,如局部应用α1肾上腺素能受体激动剂、干细胞注射、直肠注射肉毒杆菌毒素、针灸。也有一些有前景的新的侵入性技术正在出现,如肛门磁性括约肌和胃幽门移位术。这篇综述报告了目前主要可用的FI治疗方法以及正在发展的治疗工具。