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[Diagnostic in anorectal disorders].

T Frieling1

  • 1Klinik für Gastroenterologie, Hepatologie, Infektiologie, Neurogastroenterologie, Hämatologie und Onkologie, Klinikum Krefeld. Frieling@Klinikum-Krefeld.de

Praxis
|March 17, 2007
PubMed
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Fecal incontinence, often caused by anorectal disorders, affects the elderly and reduces quality of life. Diagnosis involves history and tests, with treatment focusing on symptoms and conservative methods first.

Area of Science:

  • Gastroenterology and Colorectal Surgery
  • Geriatrics
  • Quality of Life Studies

Context:

  • Anorectal disorders are a common cause of fecal incontinence, particularly in the elderly.
  • Risk factors include advanced age, female sex, and co-morbidities impacting health status.
  • These disorders impose a significant socio-economic burden and diminish quality of life.

Purpose:

  • To outline the diagnostic workup for anorectal disorders causing fecal incontinence.
  • To detail the multifactorial nature of anorectal dysfunction.
  • To emphasize a multidisciplinary, symptom-focused conservative treatment approach before considering surgery.

Summary:

  • Basic diagnostics include patient history, stool protocols, and clinical/endoscopic evaluation.

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  • Advanced investigations comprise anorectal manometry, EMG, nerve conduction studies, barostat, defecography, and dynamic MRI.
  • Treatment involves nutritional adjustments, fiber management, pharmacotherapy, toilet training, pelvic floor exercises, and biofeedback.

    • Impact:

    • Effective management improves patient quality of life by addressing depression and fear associated with fecal incontinence.
    • Conservative interventions are prioritized, with surgical options reserved for refractory cases.
    • Multidisciplinary collaboration is crucial for optimal patient outcomes in managing anorectal disorders.