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Faecal soiling: pathophysiology of postdefaecatory incontinence.
1Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. pucciani@unifi.it
Summary
Postdefaecatory incontinence, or fecal soiling, is linked to impaired defecation. This study found obstructed defecation syndrome (ODS) and reduced rectal sensitivity are key factors in passive incontinence.
Area of Science:
- Gastroenterology and Colorectal Surgery
- Pelvic Floor Disorders
Background:
- Passive postdefaecatory incontinence with fecal soiling is a poorly understood clinical issue.
- Understanding its pathophysiology is crucial for effective patient management.
Purpose of the Study:
- To characterize the pathophysiology of postdefaecatory incontinence in patients experiencing fecal soiling.
- To identify clinical and physiological markers associated with this condition.
Main Methods:
- Seventy-two patients with passive fecal incontinence and soiling were evaluated.
- Utilized endoanal ultrasound, anorectal manometry, Faecal Incontinence Severity Index (FISI), and obstructed defecation syndrome (ODS) scores.
- Compared findings with healthy controls.
Main Results:
- Group 1 (incontinence) showed significantly higher ODS scores and positive straining tests.
- Internal anal sphincter (IAS) thinning and reduced anal resting pressure were noted in Group 2 (no incontinence).
- Higher conscious rectal sensitivity threshold (CRST) was observed in incontinent patients.
Conclusions:
- Obstructed defecation syndrome (ODS), positive straining tests, and high CRST values indicate postdefaecatory incontinence stems from impaired defecation.
- These findings highlight the link between defecation dysfunction and fecal soiling.
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