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Disorders of anorectal motility: Functional defecation disorders and fecal incontinence
C Desprez1, V Bridoux2, A-M Leroi3
1Rouen University Hospital, Digestive Physiology Department, 76000 Rouen, France; Nutrition, Brain and Gut Laboratory UMR 1073, Rouen University, 76000 Rouen, France.
Abstract:
Functional defecation disorders (FDDs) and fecal incontinence (FI) are common anorectal disorders often distressing and significantly add to the healthcare burden. They present with multiple, overlapping symptoms that can often obscure the underlying pathophysiology and can pose significant management dilemmas. A detailed history, stool diaries and visual scales of stool form, a careful digital rectal examination are needed to guide anorectal physiology tests. With high-resolution (3-D) anorectal manometry, anal ultrasonography, (magnetic resonance) defecography and imaging, and neurophysiological tests, it is possible to define and characterize the underlying structural and functional abnormalities more accurately. In this review, we present a succinct update on the latest knowledge with regards to the pathophysiology, diagnosis and management of FDDS, fecal incontinence and abnormalities of rectal capacity (i.e., megarectum, microrectum).
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