The Japan Society of Coloproctology Practice Guidelines for Fecal Incontinence 2024 (Revised Second Edition)

Area of Science:

• Coloproctology
• Gastroenterology
• Urogynecology

Background:

• The Japan Society of Coloproctology (JSCP) released its second edition of Practice Guidelines for Fecal Incontinence in 2024, marking the first major revision in seven years.
• This comprehensive update involved a three-year development period, culminating in an English version for broader dissemination.

Purpose of the Study:

• To provide an updated, evidence-based framework for the diagnosis and management of fecal incontinence.
• To incorporate recent advancements in conservative and surgical treatments, including novel devices and regenerative therapies.

Main Methods:

• Systematic review and consensus-building by the JSCP committee over three years.
• Inclusion of new diagnostic tools like bowel diaries and advanced ultrasound techniques (endoanal, transperineal, transvaginal).
• Detailed outlining of conservative strategies, pharmacologic options, specialized therapies (pelvic floor training, biofeedback, transanal irrigation), and surgical interventions.

Main Results:

• Newly reported prevalence data: 15.5% of men and 42.7% of women in Japan affected by anal incontinence.
• Introduction of insertable anal and vaginal continence devices as conservative therapy options.
• Detailed guidance on managing incontinence-associated dermatitis (IAD), postpartum fecal incontinence, obstetric anal sphincter injuries (OASIS), and regenerative therapy using cultured myoblasts.

Conclusions:

• The updated guidelines offer a refined approach to fecal incontinence, emphasizing early diagnosis and tailored treatment strategies.
• Novel therapeutic options, including continence devices and regenerative medicine, are now integrated into clinical practice frameworks.
• Specialized management protocols are provided for complex cases involving neurological disorders, dementia, frailty, and the elderly.