tailieunhanh - Fecal Incontinence Diagnosis and Treatment - part 10

Các thông số lâm sàng bao gồm giảm đáng kể trong giai đoạn phân không kiểm soát và cải thiện đáng kể các thông số chất lượng cuộc sống, theo đánh giá xác nhận chất lượng của cuộc sống câu hỏi, trong thời gian khác nhau, từ 6 tháng đến hơn 5 năm. | Chapter 33 Fecal Incontinence in Elderly and Institutionalized Patients 323 has been confirmed in both short- and long-term studies 32 . Clinical parameters include substantial decrease in episodes of stool incontinence and significant improvement of quality-of-life parameters as assessed by validated quality-of-life questionnaires for periods ranging from 6 months to more than 5 years. Objective physiologic changes include increases in both resting and squeeze pressures increased squeeze durations decreased thresholds of rectal sensation and increased time of retention of a saline load. A multicenter study in the United States is currently in progress. Conclusions Fecal incontinence in the elderly is a socially devastating disorder with numerous potential etiologies. Appropriate management begins with a detailed history and physical examination that either reveal the probable cause or determine that additional diagnostic studies to elucidate pathophysiology may be required. A large array of therapeutic options is available many with little evidence to support efficacy but together they allow most incontinent patients to be managed effectively. References 1. Johanson JF Lafferty J 1996 Epidemiology of fecal incontinence the silent affliction. Am J Gastroenterol 91 33-36 2. Kok AL Voorhorst FJ Burger CW et al 1992 Urinary and fecal incontinence in community-residing elderly women. Age Ageing 21 211-215 3. Talley NJ O Keefe EA Zinsmeister AR Melton LJ 3rd 1992 Prevalence of gastrointestinal symptoms in the elderly a population-based study. Gastroenterology 102 895-901 4. Roberts RO Jacobsen SJ Reilly WT et al 1999 Prevalence of combined fecal and urinary incontinence a community based study. J Am Geriatr Soc 47 837-841 5. Bharucha AE Zinsmeister AR Locke GR et al 2005 Prevalence and burden of fecal incontinence a population based study in women. Gastroenterology 129 42-49 6. Goode PS Burgio KL Halli AD et al 2005 Prevalence and correlates of fecal incontinence in .