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大便失禁的病理生理学及治疗选择

Pathophysiology and Therapeutic Options for Fecal Incontinence.

作者信息

Guillaume Alexandra, Salem Ahmed E, Garcia Patricia, Chander Roland Bani

机构信息

*Department of Medicine, Division of Gastroenterology and Hepatology, Stony Brook University Medical Center, Stony Brook†Department of Medicine, University of Rochester Medical Center, Rochester§Department of Medicine, Division of Gastroenterology and Hepatology, Lenox Hill Hospital, Northwell Health System, New York, NY, USA‡Department of Medicine, Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, MD.

出版信息

J Clin Gastroenterol. 2017 Apr;51(4):324-330. doi: 10.1097/MCG.0000000000000797.

Abstract

Fecal incontinence (FI), defined as the involuntary loss of solid or liquid feces through the anus is a prevalent condition with significant effects on quality of life. FI can affect individuals of all ages and in many cases greatly impairs quality of life but, incontinent patients should not accept their debility as either inevitable or untreatable. The severity of incontinence can range from unintentional elimination of flatus to the complete evacuation of bowel contents. It is reported to affect up to 18% of the population, with a prevalence reaching as high as 50% in nursing home residents. However, FI is often underreported, thus obscuring its true prevalence in the general population. The options for treatment vary according to the degree and severity of the FI. Treatment can include dietary and lifestyle modification, certain medications, biofeedback therapy, bulking agent injections, sacral nerve stimulation as well as various types of surgery. In this article, we aim to provide a comprehensive review on the diagnosis and management of FI.

摘要

大便失禁(FI)被定义为粪便或液体经肛门不自主排出,是一种普遍存在的病症,对生活质量有重大影响。FI可影响所有年龄段的人,在许多情况下会极大地损害生活质量,但是,失禁患者不应将其虚弱状况视为不可避免或无法治疗。失禁的严重程度可从不自觉排气到肠道内容物完全排空。据报道,其影响高达18%的人口,在养老院居民中的患病率高达50%。然而,FI常常报告不足,从而掩盖了其在普通人群中的真实患病率。治疗方案根据FI的程度和严重程度而有所不同。治疗可包括饮食和生活方式调整、某些药物、生物反馈疗法、填充剂注射、骶神经刺激以及各种类型的手术。在本文中,我们旨在对FI的诊断和管理进行全面综述。

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