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| [PMID]: | 25533002 |
| [Au] Autor: | Bharucha AE; Dunivan G; Goode PS; Lukacz ES; Markland AD; Matthews CA; Mott L; Rogers RG; Zinsmeister AR; Whitehead WE; Rao SS; Hamilton FA |
| [Ad] Endereço: | Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. |
| [Ti] Título: | Epidemiology, pathophysiology, and classification of fecal incontinence: state of the science summary for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) workshop. |
| [So] Source: | Am J Gastroenterol;110(1):127-36, 2015 Jan. | | [Is] ISSN: | 1572-0241 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | In August 2013, the National Institutes of Health sponsored a conference to address major gaps in our understanding of the epidemiology, pathophysiology, and management of fecal incontinence (FI) and to identify topics for future clinical research. This article is the first of a two-part summary of those proceedings. FI is a common symptom, with a prevalence that ranges from 7 to 15% in community-dwelling men and women, but it is often underreported, as providers seldom screen for FI and patients do not volunteer the symptom, even though the symptoms can have a devastating impact on the quality of life. Rough estimates suggest that FI is associated with a substantial economic burden, particularly in patients who require surgical therapy. Bowel disturbances, particularly diarrhea, the symptom of rectal urgency, and burden of chronic illness are the strongest independent risk factors for FI in the community. Smoking, obesity, and inappropriate cholecystectomy are emerging, potentially modifiable risk factors. Other risk factors for FI include advanced age, female gender, disease burden (comorbidity count, diabetes), anal sphincter trauma (obstetrical injury, prior surgery), and decreased physical activity. Neurological disorders, inflammatory bowel disease, and pelvic floor anatomical disturbances (rectal prolapse) are also associated with FI. The pathophysiological mechanisms responsible for FI include diarrhea, anal and pelvic floor weakness, reduced rectal compliance, and reduced or increased rectal sensation; many patients have multifaceted anorectal dysfunctions. The type (urge, passive or combined), etiology (anorectal disturbance, bowel symptoms, or both), and severity of FI provide the basis for classifying FI; these domains can be integrated to comprehensively characterize the symptom. Several validated scales for classifying symptom severity and its impact on the quality of life are available. Symptom severity scales should incorporate the frequency, volume, consistency, and nature (urge or passive) of stool leakage. Despite the basic understanding of FI, there are still major knowledge gaps in disease epidemiology and pathogenesis, necessitating future clinical research in FI. |
| [Mh] Termos MeSH primário: |
Incontinência Fecal/classificação
Incontinência Fecal/epidemiologia
Incontinência Fecal/fisiopatologia
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| [Mh] Termos MeSH secundário: |
Canal Anal/fisiopatologia
Educação
Incontinência Fecal/etiologia
Feminino
Seres Humanos
Masculino
National Institute of Diabetes and Digestive and Kidney Diseases (U.S.)
Diafragma da Pelve/fisiopatologia
Prevalência
Qualidade de Vida
Fatores de Risco
Índice de Gravidade de Doença
Estados Unidos
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| [Pt] Tipo de publicação: | JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, U.S. GOV'T, P.H.S. |
| [Em] Mês de entrada: | 1503 |
| [Cu] Atualização por classe: | 170714 |
[Lr] Data última revisão:
| 170714 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Data de entrada para processamento: | 141224 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1038/ajg.2014.396 |
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