Japanese Practice Guidelines for Fecal Incontinence Part 2-Examination and Conservative Treatment for Fecal Incontinence- English Version
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- Maeda Kotaro
- International Medical Center Fujita Health University Hospital
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- Mimura Toshiki
- Department of Surgery, Jichi Medical University
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- Yoshioka Kazuhiko
- Department of Surgery, Kansai Medical University Medical Center
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- Seki Mihoko
- Nursing Division, Tokyo Yamate Medical Center
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- Katsuno Hidetoshi
- Department of Surgery, Fujita Health University Okazaki Medical Center
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- Takao Yoshihiko
- Division of Colorectal Surgery, Department of Surgery, Sanno Hospital
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- Tsunoda Akira
- Department of Gastroenterological Surgery, Kameda Medical Center
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- Yamana Tetsuo
- Department of Coloproctology, Tokyo Yamate Medical Center
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<p>Examination for fecal incontinence is performed in order to evaluate the condition of each patient. As there is no single method that perfectly assesses this condition, there are several tests that need to be conducted. These are as follows: anal manometry, recto anal sensitivity test, pudendal nerve terminal motor latency, electromyogram, anal endosonography, pelvic magnetic resonance imaging (MRI) scan, and defecography. In addition, the mental and physical stress most patients experience during all these examinations needs to be taken into consideration. Although some of these examinations mostly apply for patients with constipation, we hereby describe these tests as tools for the assessment of fecal incontinence.</p><p>Conservative therapies for fecal incontinence include diet, lifestyle, and bowel habit modification, pharmacotherapy, pelvic floor muscle training, biofeedback therapy, anal insert device, trans anal irrigation, and so on. These interventions have been identified to improve the symptoms of fecal incontinence by determining the mechanisms resulting in firmer stool consistency; strengthening the pelvic floor muscles, including the external anal sphincter; normalizing the rectal sensation; or periodic emptying of the colon and rectum.</p><p>Among these interventions, diet, lifestyle, and bowel habit modifications and pharmacotherapy can be performed with some degree of knowledge and experience. These two therapies, therefore, can be conducted by all physicians, including general practitioners and other physicians not specializing in fecal incontinence. However, patients with fecal incontinence who did not improve following these initial therapies should be referred to specialized institutions. Contrary to the initial therapies, specialized therapies, including pelvic floor muscle training, biofeedback therapy, anal insert device, and trans anal irrigation, should be conducted in specialized institutions as these require patient education and instructions based on expert knowledge and experience.</p><p>In general, conservative therapies should be performed for fecal incontinence before surgery because its pathophysiologies are mostly attributed to benign conditions. All Japanese healthcare professionals who take care of patients with fecal incontinence are expected to understand the characteristics of each conservative therapy, so that appropriate therapies will be selected and performed. Therefore, in this chapter, the characteristics of each conservative therapy for fecal incontinence are described.</p>
収録刊行物
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- Journal of the Anus, Rectum and Colon
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Journal of the Anus, Rectum and Colon 5 (1), 67-83, 2021-01-28
一般社団法人日本大腸肛門病学会
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詳細情報
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- CRID
- 1391975831239361920
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- NII論文ID
- 130007976103
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- ISSN
- 24323853
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可